Individual
LORI S JETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1805 VERNON ROAD, STUITE A, LAGRANGE, GA 30240-3871
(706) 845-9383
(706) 845-9482
Mailing address
1805 VERNON ROAD, STUITE A, LAGRANGE, GA 30240-3871
(706) 845-9383
(706) 845-9482
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002298
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000564561C
—
GA
Enumeration date
04/14/2006
Last updated
07/13/2021
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