MEDICARE: HOLLY LANCASTER 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	3357	AZ

General Provider Information

NPI Number	:	1760624209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY LANCASTER OT

Provider Business Mailing Address
First Line	:	6001 E THOMAS RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7511
Country	:	US
Telephone Number	:	480-941-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 E THOMAS RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7511
Country	:	US
Telephone Number	:	480-941-2222
Fax Number	:

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

Provider Enumeration Date	:	03/30/2009
Last Update Date	:	02/22/2021

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Directions to “ HOLLY LANCASTER OT” Practice Location

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