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NPI Code Detail

MEDICARE: EVAN LUNDQUIST OTR/L

MEDICARE:   EVAN  LUNDQUIST  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
1225X00000XOccupational TherapistOT011468OH

General Provider Information

NPI Number : 1477284685
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVAN LUNDQUIST OTR/L
Provider Business Mailing Address
First Line : 14396 POLO CLUB DR BLDG 9
Second Line :
City : STRONGSVILLE
State : OH
Zip : 44136-8922
Country : US
Telephone Number : 419-612-2873
Fax Number :
Provider Business Practice Location Address
First Line : 100 BROOKMONT RD
Second Line :
City : AKRON
State : OH
Zip : 44333-9207
Country : US
Telephone Number : 330-666-4545
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2022
Last Update Date : 06/19/2022

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Directions to “ EVAN LUNDQUIST OTR/L” Practice Location

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