Individual
LORI M MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6841 IVY ST, COMMERCE CITY, CO 80022-2539
(720) 280-3993
Mailing address
6841 IVY ST, COMMERCE CITY, CO 80022-2539
(720) 280-3993
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
288566
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
288566
NPI NUMBER
CO
Enumeration date
05/07/2013
Last updated
05/07/2013
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