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General NPI Number Information
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NPI Number | 1861614554
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Entity Type | Individual
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Provider Name | LAURA LINVILLE OTR
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2614 N JOPLIN ST
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City | PITTSBURG
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State | KS
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Zip | 66762-2643
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Country | US
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Telephone | 620-231-3970
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Fax |
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Provider Business Mailing Address
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Address Line | 3206 E 20TH ST
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City | PITTSBURG
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State | KS
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Zip | 66762-7400
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Country | US
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Telephone | 620-232-3900
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Fax |
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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 | 1701690
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License Number State | KS
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