MEDICARE: TOM LAMPKE OT

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	KY-R2506	KY

General Provider Information

NPI Number	:	1457431728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOM LAMPKE OT

Provider Business Mailing Address
First Line	:	2222 SULLIVAN TRL
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18040-7958
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 FARRELL DR
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-3785
Country	:	US
Telephone Number	:	859-341-0777
Fax Number	:

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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Directions to “ TOM LAMPKE OT” Practice Location

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