Provider Demographics
NPI:1912602178
Name:SPECK, LOTTIE MAY
Entity Type:Individual
Prefix:PROF
First Name:LOTTIE
Middle Name:MAY
Last Name:SPECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N7407 690TH ST
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-6002
Mailing Address - Country:US
Mailing Address - Phone:715-308-3870
Mailing Address - Fax:
Practice Address - Street 1:N7407 690TH ST
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-6002
Practice Address - Country:US
Practice Address - Phone:715-308-3870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care