MEDICARE: LORAINE JOAN ZAGULA OTR

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	174400000X	Specialist	0450	AZ

General Provider Information

NPI Number	:	1548309412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORAINE JOAN ZAGULA OTR

Provider Business Mailing Address
First Line	:	1613 E ADELAIDE DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-2721
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 E ADELAIDE DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-2721
Country	:	US
Telephone Number	:	520-327-7587
Fax Number	:

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/08/2007

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