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Individual

MR. LANCE MICHAEL NORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MOT, OTR/L, CHT

Contact information

Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 281-9377
(218) 281-9336
Mailing address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 281-9377
(218) 281-9336

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
423
ND
225X00000X
Occupational Therapist
Primary
978472
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1042277
PREFERRED ONE
01
221978600
MEDICAL ASSISTANCE
MN
01
24559
ND BCBS
ND
01
24559
NORIDIAN MUTUAL
01
24781
ND BCBS
ND
01
24781
DEMERS LOCATION
01
2605852
UNITED HEALTH CARE
01
340M9NO
BCBS MN
05
54902
ND
01
64-05686
MEDICA
01
6405687
DEMERS LOCATION
01
747655800
MEDICAL ASSISTANCE
MN
01
HP62196
HEALTH PARTNERS
Enumeration date
01/25/2006
Last updated
10/22/2012
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