Individual
MR. ANTONIO LORA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,ATC, PES
Contact information
Practice address
192 TILLEY DR, MAIL STOP 4380 C1, SOUTH BURLINGTON, VT 05403-4440
(802) 847-7001
Mailing address
192 TILLEY DR, SOUTH BURLINGTON, VT 05403-4440
(802) 847-7001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
104-0000135
VT
Other
Enumeration date
09/17/2008
Last updated
07/02/2019
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