Provider Demographics
NPI:1215374137
Name:LAGRAFF, MICHAEL ALEXANDER (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALEXANDER
Last Name:LAGRAFF
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9051 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4606
Mailing Address - Country:US
Mailing Address - Phone:865-200-5127
Mailing Address - Fax:
Practice Address - Street 1:9051 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 600
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4606
Practice Address - Country:US
Practice Address - Phone:865-200-5127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-01
Last Update Date:2013-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4734225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics