=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073066833
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LYNN VOSBEEK OTR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2016
-----------------------------------------------------
Last Update Date | 07/28/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6065 S QUEBEC ST
-----------------------------------------------------
City | ENGLEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-4524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 184-442-2266
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9061 KENWOOD CT
-----------------------------------------------------
City | HIGHLANDS RANCH
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80126-3420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-263-1830
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT.0000891
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------