Provider Demographics
NPI:1306997705
Name:LOTT, MATTHEW R (OT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:LOTT
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 EMBASSY PKWY
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-1763
Mailing Address - Country:US
Mailing Address - Phone:330-668-4040
Mailing Address - Fax:330-668-4090
Practice Address - Street 1:3925 EMBASSY PKWY
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-1763
Practice Address - Country:US
Practice Address - Phone:330-668-4040
Practice Address - Fax:330-668-4090
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT4296225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4200546Medicare PIN