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Individual

LORI LYNN ROELOFS

Active
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Individual

LORI LYNN ROELOFS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPT

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
25455
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPT254550
BLUE CROSS PROVIDER ID
CA
Enumeration date
06/23/2010
Last updated
10/16/2011
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