Individual
MRS. LORI ANN HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
159 W 1ST ST, OSWEGO, NY 13126-2045
(315) 342-9575
Mailing address
8237 EXETER DR, BALDWINSVILLE, NY 13027-1001
(315) 303-4106
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002018-1
NY
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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