MEDICARE: MATTHEW LAWRENCE PRESS OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	3880	AZ
2	225X00000X	Occupational Therapist	OT9283	FL

General Provider Information

NPI Number	:	1083669212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW LAWRENCE PRESS OTR/L

Provider Business Mailing Address
First Line	:	5641 W WOOD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-6324
Country	:	US
Telephone Number	:	602-283-4556
Fax Number	:

Provider Business Practice Location Address
First Line	:	5641 W WOOD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-6324
Country	:	US
Telephone Number	:	602-283-4556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/26/2007

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