Miyazato, Lori J

Miyazato, Lori J is an individual health care provider with primary practice located at 620 W Brown St , Waupun WI 53963-1702. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Miyazato, Lori J can be contacted via phone (920) 324-6544.

Contact Information

Primary practice address
620 W Brown St Waupun WI 53963-1702
Fax:
Website:

Health care specialties

Profile Details

NPI number 1659328854
LBN Legal business name Miyazato, Lori J
Credentials Registered Occupational Therapist (OTR)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Aug 16th, 2007 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659328854 NPPES
Wisconsin MEDICAID 40861500

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