Individual
MR. MICHAEL J E FYFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
2624 ESPINOZA ST, TRINIDAD, CO 81082-3913
(419) 508-3996
Mailing address
2624 ESPINOZA ST, TRINIDAD, CO 81082-3913
(419) 508-3996
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0002493
CO
225X00000X
Occupational Therapist
OT6357
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000142280
—
CO
Enumeration date
04/12/2007
Last updated
02/16/2017
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