Provider Demographics
NPI:1215123906
Name:ANDERSON, LORI A (MSPT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 BOW CIR STE B
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-3277
Mailing Address - Country:US
Mailing Address - Phone:843-842-4737
Mailing Address - Fax:843-842-4738
Practice Address - Street 1:37 BOW CIR STE B
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-3277
Practice Address - Country:US
Practice Address - Phone:843-842-4737
Practice Address - Fax:843-842-4738
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3081225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist