Individual
LORI ANNE MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC,LAT
Contact information
Practice address
722 COLUMBIA LN, DEER PARK, TX 77536-6308
(832) 256-4621
Mailing address
722 COLUMBIA LN, DEER PARK, TX 77536-6308
(832) 256-4621
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2128
TX
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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