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General NPI Number Information
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NPI Number | 1598941874
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Entity Type | Individual
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Provider Name | ZACHARY TODD LAWRENCE MS/OTR
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Gender | Male
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 419 LEWISTON RD STE 3
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City | GROVETOWN
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State | GA
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Zip | 30813-4290
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Country | US
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Telephone | 706-945-0420
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Fax | 706-945-0288
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-238-7217
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Fax | 423-238-3473
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31004516A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT005638
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License Number State | GA
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