| NPI | 1487102695 |
|---|---|
| Former Name | LORI RENAE TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12125) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 9636095-2401) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |