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NPI Code Detail

MEDICARE: MS. LAUREN KOEGLER OTR

MEDICARE: MS. LAUREN KOEGLER OTR
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 Therapist4903-26WI

General Provider Information

NPI Number : 1417395427
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAUREN KOEGLER OTR
Provider Business Mailing Address
First Line : 9350 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53225-1714
Country : US
Telephone Number : 414-393-4614
Fax Number :
Provider Business Practice Location Address
First Line : 9350 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53225-1714
Country : US
Telephone Number : 414-393-4614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2013
Last Update Date : 06/12/2013

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