| 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 | 2024-06-27 |