Provider Demographics
NPI:1467688077
Name:LEE-TOSH, LAURY ANN (OTR)
Entity Type:Individual
Prefix:
First Name:LAURY
Middle Name:ANN
Last Name:LEE-TOSH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 GREENBRAE DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8173
Mailing Address - Country:US
Mailing Address - Phone:541-857-2888
Mailing Address - Fax:
Practice Address - Street 1:302 E HERSEY ST
Practice Address - Street 2:SUITE #9
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1200
Practice Address - Country:US
Practice Address - Phone:541-857-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR543579225X00000X, 225XN1300X, 225XP0019X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation