Individual
MRS. LORI DOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
118 HERRON STREET, FT OGLETHORPE, GA 30742
(706) 861-7471
(706) 861-7472
Mailing address
118 HERRON STREET, FT OGLETHORPE, GA 30742
(706) 861-7471
(706) 861-7472
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006958
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00892339A
—
GA
01
—
339821
WELLCARE
—
01
—
4003038
BCBS
TN
01
—
52875655001
BCBS
GA
Enumeration date
12/01/2006
Last updated
07/08/2007
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