MEDICARE: MR. ROBERT TRAHAN LOTR

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	OTT.Z11771	LA
2	225XL0004X	Low Vision Occupational Therapist	OTT.Z11771	LA

General Provider Information

NPI Number	:	1891813051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT TRAHAN LOTR

Provider Business Mailing Address
First Line	:	12338 NORTHWOOD XING
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-6014
Country	:	US
Telephone Number	:	985-969-5039
Fax Number	:	833-644-0884

Provider Business Practice Location Address
First Line	:	12338 NORTHWOOD XING
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-6014
Country	:	US
Telephone Number	:	985-969-5039
Fax Number	:	985-902-8587

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/11/2022

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