Individual
LORI A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1260 INDEPENDENCE AVE, AKRON, OH 44310-1812
(330) 633-8400
Mailing address
1260 INDEPENDENCE AVE, AKRON, OH 44310-1812
(330) 633-8400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT05013
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT - 5013
OHIO PT LICENSE
—
Enumeration date
06/29/2006
Last updated
06/17/2015
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