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NPI Code Detail

MEDICARE: LAURIN MCGILLIS

MEDICARE: LAURIN MCGILLIS
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
1225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1164261616
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIN MCGILLIS
Provider Business Mailing Address
First Line : 5300 STINSON AVE
Second Line :
City : SUPERIOR
State : WI
Zip : 54880-6313
Country : US
Telephone Number : 715-817-0525
Fax Number : 866-882-3314
Provider Business Practice Location Address
First Line : 5300 STINSON AVE
Second Line :
City : SUPERIOR
State : WI
Zip : 54880-6313
Country : US
Telephone Number : 715-817-0525
Fax Number : 866-882-3314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2024
Last Update Date : 12/30/2025

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Directions to “ LAURIN MCGILLIS ” Practice Location

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