Most Relevant Information
Provider Data
| NPI Number: | 1003687583 |
| Provider Name: | KASSIE TANNEHILL LOTR |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 340116 |
Most Important Dates
| Enumeration Date: | 01/12/2024 |
| Last Updated: | 01/12/2024 |
Provider Practice Location
109 DESPERADO RD
TROUT
LA
713714501
Practice Location Phone/Fax
| Phone: | 3183163020 |
| Fax: |
Provider Mailing Location
109 DESPERADO RD
TROUT
LA
713714501
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |