MEDICARE: LISE GERVAIS OT

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
1	225X00000X	Occupational Therapist	6044	MA

General Provider Information

NPI Number	:	1497731186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISE GERVAIS OT

Provider Business Mailing Address
First Line	:	155 GEORGE WASHINGTON BLVD
Second Line	:	UNIT 410
City	:	HULL
State	:	MA
Zip	:	02045-3000
Country	:	US
Telephone Number	:	508-923-6032
Fax Number	:	508-923-6361

Provider Business Practice Location Address
First Line	:	109 RHODE ISLAND RD
Second Line	:	SHRIVER
City	:	LAKEVILLE
State	:	MA
Zip	:	02347-1370
Country	:	US
Telephone Number	:	508-923-6032
Fax Number	:	508-923-6361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1053302042 — MOBILE MEDICAL RADIOGRAPHY AND EKG INC
Practice Location Address:

109 RHODE ISLAND RD , CLEAR POND OFFICES
LAKEVILLE, MA
02347-1370

Practice Phone: 508-923-6171
Practice Fax: 508-923-6248

1891771564 — JOANNA S BRIODY PT
Practice Location Address:

109 RHODE ISLAND RD , SHRIVER
LAKEVILLE, MA
02347-1370

Practice Phone: 508-923-6032
Practice Fax: 508-923-6361

1356502462 — MS. LISA ANN FERREIRA MA, LMHC
Practice Location Address:

109 RHODE ISLAND RD STE 4B
LAKEVILLE, MA
02347-1370

Practice Phone: 508-203-6908
Practice Fax: 508-796-1468

1801112099 — MOBILE MEDICAL GROUP MA PC
Practice Location Address:

109 RHODE ISLAND RD
LAKEVILLE, MA
02347-1370

Practice Phone: 781-489-5717
Practice Fax: 781-772-1332

1073830733 — MOBILE MEDICAL OPTOMETRY MA PC
Practice Location Address:

109 RHODE ISLAND RD
LAKEVILLE, MA
02347-1370

Practice Phone: 508-823-9307
Practice Fax:

1194095406 — JENNA LEE ELLIS MA, LMHC
Practice Location Address:

109 RHODE ISLAND RD STE D
LAKEVILLE, MA
02347-1370

Practice Phone: 774-955-0494
Practice Fax: 774-250-3210

Directions to “ LISE GERVAIS OT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.