MEDICARE: MRS. CASSIE LYNN LOZANOVSKI 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	225X00000X	Occupational Therapist	2609	AZ

General Provider Information

NPI Number	:	1982746681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASSIE LYNN LOZANOVSKI OTR

Provider Business Mailing Address
First Line	:	22706 W SIERRA RIDGE WAY
Second Line	:
City	:	WITTMANN
State	:	AZ
Zip	:	85361-8788
Country	:	US
Telephone Number	:	623-388-0910
Fax Number	:

Provider Business Practice Location Address
First Line	:	22706 W SIERRA RIDGE WAY
Second Line	:
City	:	WITTMANN
State	:	AZ
Zip	:	85361-8788
Country	:	US
Telephone Number	:	623-388-0910
Fax Number	:

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	09/19/2014

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