Healthcare Provider Details

I. General information

NPI: 1043524259
Provider Name (Legal Business Name): LYTLE AND ASSOCIATES SPECIALIZED THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SUNSET BLVD
STEUBENVILLE OH
43952-1158
US

IV. Provider business mailing address

2700 SUNSET BLVD
STEUBENVILLE OH
43952-1158
US

V. Phone/Fax

Practice location:
  • Phone: 740-264-7505
  • Fax: 740-264-7535
Mailing address:
  • Phone: 740-264-7505
  • Fax: 740-264-7535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number1041100185
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT004994
License Number StateOH

VIII. Authorized Official

Name: LISA M LYTLE
Title or Position: OWNER
Credential: OT
Phone: 740-264-7505