| NPI | 1619963766 |
|---|---|
| Former Name | LORI L JORGENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1157) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 03352) |
| 225100000X Physical Therapist (Licence: MN 6924) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2007-07-08 |