MEDICARE: STACY LOIS

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	OC007361L	PA

General Provider Information

NPI Number	:	1841483971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY LOIS

Provider Business Mailing Address
First Line	:	28 BUTTON BUCK DR
Second Line	:
City	:	CONESTOGA
State	:	PA
Zip	:	17516-9412
Country	:	US
Telephone Number	:	412-315-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 BUTTON BUCK DR
Second Line	:
City	:	CONESTOGA
State	:	PA
Zip	:	17516-9412
Country	:	US
Telephone Number	:	412-315-4500
Fax Number	:

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

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	02/08/2022

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Directions to “ STACY LOIS ” Practice Location

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