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NPI Code Detail

MEDICARE: LAURIE RENEE SPANGLE-BAUER OTR

MEDICARE: LAURIE RENEE SPANGLE-BAUER 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
1225X00000XOccupational Therapist3389-026WI

General Provider Information

NPI Number : 1871767517
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE RENEE SPANGLE-BAUER OTR
Provider Business Mailing Address
First Line : 1319 BEASER AVE
Second Line :
City : ASHLAND
State : WI
Zip : 54806-3614
Country : US
Telephone Number : 715-682-3468
Fax Number : 715-682-8878
Provider Business Practice Location Address
First Line : 1319 BEASER AVE
Second Line :
City : ASHLAND
State : WI
Zip : 54806-3614
Country : US
Telephone Number : 715-682-3468
Fax Number : 715-682-8878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2008
Last Update Date : 04/14/2008

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Directions to “ LAURIE RENEE SPANGLE-BAUER OTR” Practice Location

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