| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LAUREN VISTARAKULA | 1477170512 | 2020-07-05 |
Lauren Vistarakula is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1477170512. Registration indicates Lauren Vistarakula is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Occupational Therapist (Occupational Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Lauren Vistarakula OTR/L |
| Other Provider Name | Lauren Pittard |
| Practice Office Address | 4335 BRAMBLETON AVE ROANOKE, VA US |
| Practice Office Telephone | 5403153210 |
| Practice Office Fax | 5405665149 |
| Mailing Address | 4335 BRAMBLETON AVE ROANOKE, VA 240183404 US |
| Business Telephone | 5403153210 |
| Business Fax | 5405665149 |
| Code | Practice | License No State |
|---|---|---|
| 225X00000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapist Occupational Therapist Speech/Occupational/Physical Therapy/Chiropractor Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 0119007276
VA |