Individual
LORI DE SIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2634 GLENN ST, BETTENDORF, IA 52722-3824
(707) 703-9729
Mailing address
2634 GLENN ST, BETTENDORF, IA 52722-3824
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00802
IA
225200000X
Physical Therapy Assistant
160.006322
IL
225200000X
Physical Therapy Assistant
AT 6448
CA
Other
Enumeration date
09/11/2013
Last updated
09/11/2013
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