Lora Linn Wilson, PTA
Individual provider Active NPI Physical Therapy Assistant · Gaston, IN
NPI 1386955367 · NPPES record last updated Jun 24, 2010
Key facts
- NPI
- 1386955367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 06001901A (IN)
- Practice address
- 8000 N County Road 600 W
Gaston, IN 47342-9339 - Phone
- (765) 358-3851
- NPI assigned
- Jun 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06001901A | IN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06001901A | IN | Yes |
Addresses
Primary practice location
8000 N County Road 600 W
Gaston, IN 47342-9339
Mailing address
8000 N County Road 600 W
Gaston, IN 47342-9339
Other providers in Gaston, IN
All providers in Gaston, IN · Physical Therapy Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.