Lori Flanary, PTA

Individual provider Active NPI Physical Therapy Assistant · Eureka, IL

NPI 1104643956 · NPPES record last updated Sep 23, 2024

Key facts

NPI
1104643956
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160006824 (IL)
Practice address
504 Dennis Dr
Eureka, IL 61530-1675
Phone
(815) 674-5904
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
160006824ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160006824 IL Yes

Addresses

Primary practice location

504 Dennis Dr
Eureka, IL 61530-1675

Mailing address

504 Dennis Dr
Eureka, IL 61530-1675
Phone (815) 674-5904

Other providers in Eureka, IL

All providers in Eureka, IL · Physical Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.