Individual
MRS. LORI SUE POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
25 S BOEHNE CAMP RD, EVANSVILLE, IN 47712-3101
(812) 401-6101
Mailing address
25 S BOEHNE CAMP RD, EVANSVILLE, IN 47712-3101
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06000581A
IN
Other
Enumeration date
03/05/2010
Last updated
03/05/2010
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