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NPI Code Detail

MEDICARE: FREDERICK CHARLES LUSK OTR/L

MEDICARE:   FREDERICK CHARLES LUSK  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist0119006519VA

General Provider Information

NPI Number : 1326825407
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICK CHARLES LUSK OTR/L
Provider Business Mailing Address
First Line : 10051 FOXES WAY
Second Line :
City : KING GEORGE
State : VA
Zip : 22485-3458
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10051 FOXES WAY
Second Line :
City : KING GEORGE
State : VA
Zip : 22485-3458
Country : US
Telephone Number : 540-775-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2023
Last Update Date : 09/12/2023

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Directions to “ FREDERICK CHARLES LUSK OTR/L” Practice Location

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