Provider Demographics
NPI:1801986328
Name:LAWLER, MICHAEL (OTR)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:LAWLER
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13680 SUNNY KNOLLS LN
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-8316
Mailing Address - Country:US
Mailing Address - Phone:970-522-2869
Mailing Address - Fax:
Practice Address - Street 1:7TH MAIN
Practice Address - Street 2:WRAC
Practice Address - City:WRAY
Practice Address - State:CO
Practice Address - Zip Code:80758
Practice Address - Country:US
Practice Address - Phone:970-332-3471
Practice Address - Fax:970-332-3487
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA572628225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066589Medicare ID - Type Unspecified