Basic Information
| Provider Information | |||||||||
| NPI: | 1265709505 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOMBARD | ||||||||
| FirstName: | MARIE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4725 MERLE HAY RD SUITE #107 | ||||||||
| Address2: | MILLENNIUM | ||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 50322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153313190 | ||||||||
| FaxNumber: | 5153313191 | ||||||||
| Practice Location | |||||||||
| Address1: | 3720 QUEEN CT SW | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 524044735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193659439 | ||||||||
| FaxNumber: | 3193659368 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2011 | ||||||||
| LastUpdateDate: | 04/08/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 01725 | IA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.