Lori Conner, PTA

Individual provider Active NPI Physical Therapy Assistant · Crane, MO

NPI 1770730640 · NPPES record last updated Aug 22, 2008

Key facts

NPI
1770730640
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2001005034 (MO)
Practice address
509 Meadowlark Ave
Crane, MO 65633-9317
Phone
(417) 535-6255
NPI assigned
Aug 22, 2008
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
2001005034MOMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2001005034 MO Yes

Addresses

Primary practice location

509 Meadowlark Ave
Crane, MO 65633-9317

Mailing address

509 Meadowlark Lane
Crane, MO 65633
Phone (417) 535-6255

Other providers in Crane, MO

All providers in Crane, MO · Physical Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.