Provider Demographics
NPI:1215301395
Name:ROOP, LORI
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:ROOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14715 W 64TH AVE UNIT H
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3544
Mailing Address - Country:US
Mailing Address - Phone:303-898-3597
Mailing Address - Fax:
Practice Address - Street 1:14715 W 64TH AVE UNIT H
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3544
Practice Address - Country:US
Practice Address - Phone:303-898-3597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator