Individual
MRS. LORI ANN LINVILLE-PETRIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2585 MIRACLE MILE, SUITE 107, BULLHEAD CITY, AZ 86442-7522
(928) 444-8168
(928) 444-8169
Mailing address
2585 MIRACLE MILE, SUITE 107, BULLHEAD CITY, AZ 86442-7522
(928) 444-8168
(928) 444-8169
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1193
NV
225100000X
Physical Therapist
Primary
4214
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1193
LICENSURE
NV
01
—
4214
LICENSURE
AZ
Enumeration date
09/20/2006
Last updated
06/22/2012
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