Ricardo Prado

Individual provider Active NPI Occupational Therapist · Rawlins, WY

NPI 1679902845 · NPPES record last updated Nov 7, 2013

Key facts

NPI
1679902845
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OTR-1037 (WY)
Practice address
542 16TH St
Rawlins, WY 82301-5241
Phone
(307) 324-2759
NPI assigned
Nov 7, 2013
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
OTR-1037WYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTR-1037 WY Yes

Addresses

Primary practice location

542 16TH St
Rawlins, WY 82301-5241

Mailing address

5001 Statesman Dr
Irving, TX 75063-2414

Other providers in Rawlins, WY

All providers in Rawlins, WY · Occupational Therapist in Wyoming

Sources for this page

Verify at the official NPI Registry.