Individual
MRS. LORI LYNNE HARDACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13555 W MCDOWELL RD, SUITE 101, GOODYEAR, AZ 85395-2624
(623) 935-4700
(623) 935-4707
Mailing address
9250 N. 3RD ST, SUITE 4010, PHOENIX, AZ 85020
(602) 633-3838
(602) 633-3841
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4617
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
526932
—
AZ
Enumeration date
06/28/2006
Last updated
03/11/2013
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