Provider Demographics
NPI:1184846016
Name:ESKRO, LISA GAIL (OT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:GAIL
Last Name:ESKRO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 CAPITAL AVE
Mailing Address - Street 2:SUITE #205
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015
Mailing Address - Country:US
Mailing Address - Phone:269-979-0874
Mailing Address - Fax:269-979-0901
Practice Address - Street 1:3600 CAPITAL AVE
Practice Address - Street 2:SUITE #205
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015
Practice Address - Country:US
Practice Address - Phone:269-979-0874
Practice Address - Fax:269-979-0901
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002582225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
ON24980Medicare ID - Type Unspecified