| NPI | 1790520138 | 
|---|---|
| Former Legal Business Name | LAKE MURRAY OT | 
| Entity Type | Organization | 
| Authorized Contact | ZACHARY E FOSS Lead Therapist 757-353-8094  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 225X00000X Occupational Therapist | 
| Enumeration Date | 2024-06-27 | 
| Last Update Date | 2025-02-20 |