Provider Demographics
NPI:1932489358
Name:BUCK, LORI MOOT (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:MOOT
Last Name:BUCK
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 21ST AVE S
Mailing Address - Street 2:MEDICAL CENTER EAST SOUTH TOWER, 6TH FLOOR
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0014
Mailing Address - Country:US
Mailing Address - Phone:615-936-5000
Mailing Address - Fax:
Practice Address - Street 1:1215 21ST AVE S
Practice Address - Street 2:MEDICAL CENTER EAST SOUTH TOWER, 6TH FLOOR
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0014
Practice Address - Country:US
Practice Address - Phone:615-936-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4421225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics