MEDICARE: MR. FRANCIS JOHN LOMMERSE 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	OT03548	OH

General Provider Information

NPI Number	:	1558354118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANCIS JOHN LOMMERSE OT

Provider Business Mailing Address
First Line	:	676 MIAMI ST
Second Line	:	SUITE A
City	:	TIFFIN
State	:	OH
Zip	:	44883-1934
Country	:	US
Telephone Number	:	419-448-5533
Fax Number	:	419-448-5559

Provider Business Practice Location Address
First Line	:	676 MIAMI ST
Second Line	:	SUITE A
City	:	TIFFIN
State	:	OH
Zip	:	44883-1934
Country	:	US
Telephone Number	:	419-448-5533
Fax Number	:	419-448-5559

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

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	07/08/2007

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