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NPI Code Detail

MEDICARE: LORI KATHERINE EHMANN OTR

MEDICARE:   LORI KATHERINE EHMANN  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
1225XP0200XPediatric Occupational TherapistOT12383FL

General Provider Information

NPI Number : 1811199482
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI KATHERINE EHMANN OTR
Provider Business Mailing Address
First Line : 101 OCEAN WAY DR
Second Line :
City : PONCE INLET
State : FL
Zip : 32127-7321
Country : US
Telephone Number : 386-295-6561
Fax Number :
Provider Business Practice Location Address
First Line : 900 N SWALLOW TAIL DR STE 107
Second Line :
City : PORT ORANGE
State : FL
Zip : 32129-6103
Country : US
Telephone Number : 386-446-9935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 12/26/2024

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Directions to “ LORI KATHERINE EHMANN OTR” Practice Location

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