Javier Alvarez, COTA

Individual provider Active NPI Occupational Therapy Assistant · Prairie Du Chien, WI

NPI 1619027166 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619027166
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
1502027 (WI)
Practice address
705 E Taylor St
Prairie Du Chien, WI 53821-2110
Phone
(608) 357-2000
Fax
(608) 357-2254
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1502027WIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1502027 WI Yes

Addresses

Primary practice location

705 E Taylor St
Prairie Du Chien, WI 53821-2110

Mailing address

705 E Taylor St
Prairie Du Chien, WI 53821-2110
Phone (608) 357-2000

Other identifiers

IdentifierTypeStateIssuer
40846200MedicaidWI

Other providers in Prairie Du Chien, WI

All providers in Prairie Du Chien, WI · Occupational Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.