MEDICARE: MR. DOUGLAS J LAUBER OTR/L,CHT

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	2970	SC
2	225XH1200X	Hand Occupational Therapist	1051100620	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669569190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DOUGLAS J LAUBER OTR/L,CHT

Provider Business Mailing Address
First Line	:	501 FOREST LN
Second Line	:	SUITE A
City	:	CLEMSON
State	:	SC
Zip	:	29631-2621
Country	:	US
Telephone Number	:	864-654-2001
Fax Number	:	800-305-7112

Provider Business Practice Location Address
First Line	:	501 FOREST LN
Second Line	:	SUITE A
City	:	CLEMSON
State	:	SC
Zip	:	29631-2621
Country	:	US
Telephone Number	:	864-654-2001
Fax Number	:	800-305-7112

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/27/2016

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Directions to “ MR. DOUGLAS J LAUBER OTR/L,CHT” Practice Location

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