Provider Demographics
NPI:1790977403
Name:GUINN, LONNIE ROY (OTR/L)
Entity Type:Individual
Prefix:
First Name:LONNIE
Middle Name:ROY
Last Name:GUINN
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 1:1362 LOOWIT FALLS WAY
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-3437
Mailing Address - Country:US
Mailing Address - Phone:770-842-7131
Mailing Address - Fax:
Practice Address - Street 1:1362 LOOWIT FALLS WAY
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-3437
Practice Address - Country:US
Practice Address - Phone:770-842-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist