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Individual

MR. TIMOTHY R LUPIEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
5041 DALLAS HWY BLDG 1C, POWDER SPRINGS, GA 30127-6459
(770) 425-2151
(770) 425-5982
Mailing address
5041 DALLAS HWY BLDG 1C, POWDER SPRINGS, GA 30127-6459
(770) 425-2151
(770) 425-5982

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT000594
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GRP7271
MEDICARE LEGACY/PTAN
GA
Enumeration date
12/19/2006
Last updated
12/10/2007
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