Provider Demographics
NPI:1063632024
Name:VOLL, CORRY LYNN (OTR)
Entity type:Individual
Prefix:MRS
First Name:CORRY
Middle Name:LYNN
Last Name:VOLL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 OLD OAK DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE BRA
Mailing Address - State:IN
Mailing Address - Zip Code:47906-9701
Mailing Address - Country:US
Mailing Address - Phone:765-463-1706
Mailing Address - Fax:
Practice Address - Street 1:2400 SOUTH ST
Practice Address - Street 2:HOME HOSPITAL REHABILITATION UNIT
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-3027
Practice Address - Country:US
Practice Address - Phone:765-449-5106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002960A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist