Healthcare Provider Details

I. General information

NPI: 1386160935
Provider Name (Legal Business Name): PATRICIA JOSEPHINE LOHR OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 WESTERN AVE
MANITOWOC WI
54220-3712
US

IV. Provider business mailing address

2300 WESTERN AVE
MANITOWOC WI
54220-3712
US

V. Phone/Fax

Practice location:
  • Phone: 920-320-2250
  • Fax: 920-320-5114
Mailing address:
  • Phone: 920-320-2250
  • Fax: 920-320-5114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number666-27
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number666-27
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: