| Brooke Bottila, PT | |
|
4195 Westberg Rd, Hermantown, MN 55811-2962 | |
| (218) 216-9921 | |
| Not Available |
| Full Name | Brooke Bottila |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 4195 Westberg Rd, Hermantown, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649031923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
| Provider Name | Caring Edge Op Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1700399359 PECOS PAC ID: 6406114131 Enrollment ID: O20180802001325 |
| Mailing Address | Practice Location Address |
|---|---|
| Brooke Bottila, PT 540 Falcon Crest Dr, Spearfish, SD 57783-3252 Ph: (605) 491-2832 | Brooke Bottila, PT 4195 Westberg Rd, Hermantown, MN 55811-2962 Ph: (218) 216-9921 |
Casey Headlee, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4195 Westberg Rd, Hermantown, MN 55811 Phone: 218-216-9921 | |
Brittany Christine Malvick, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4195 Westberg Rd, Hermantown, MN 55811 Phone: 218-491-3219 | |
Matthew Mcintyre, MOT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4195 Westberg Rd, Hermantown, MN 55811 Phone: 218-216-9921 | |
Cody Dunkley, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 5155 Miller Trunk Hwy, Hermantown, MN 55811 Phone: 218-729-7150 |