Provider Demographics
NPI:1679832976
Name:HOVLAND, TORREY LEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:TORREY
Middle Name:LEE
Last Name:HOVLAND
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 1:24864 TRI LAKES DR
Mailing Address - Street 2:
Mailing Address - City:PELICAN RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56572-7555
Mailing Address - Country:US
Mailing Address - Phone:701-388-9731
Mailing Address - Fax:218-863-2215
Practice Address - Street 1:24864 TRI LAKES DR
Practice Address - Street 2:
Practice Address - City:PELICAN RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56572-7555
Practice Address - Country:US
Practice Address - Phone:701-388-9731
Practice Address - Fax:218-863-2215
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND959225X00000X
MN104222225X00000X
MN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist