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NPI Code Detail

MEDICARE: LALAINE S DUABAN OTR

MEDICARE: LALAINE S DUABAN 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 Therapist0001355MO

General Provider Information

NPI Number : 1518065143
Entity Type Code : Individual
Provider Name (Legal Business Name) : LALAINE S DUABAN OTR
Provider Business Mailing Address
First Line : 5859 S. TETERS CT.
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804
Country : US
Telephone Number : 417-889-9575
Fax Number :
Provider Business Practice Location Address
First Line : 2800 S FORT AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3480
Country : US
Telephone Number : 417-882-0035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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Directions to “ LALAINE S DUABAN OTR” Practice Location

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