Provider Demographics
NPI:1285868505
Name:LLOYD, LORI (LAC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:LLOYD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:112 ASPEN MEADOWS RD
Mailing Address - Street 2:UNIT 41
Mailing Address - City:DRIGGS
Mailing Address - State:ID
Mailing Address - Zip Code:83422-5352
Mailing Address - Country:US
Mailing Address - Phone:208-920-0312
Mailing Address - Fax:
Practice Address - Street 1:76 N MAIN ST
Practice Address - Street 2:STE. 204
Practice Address - City:DRIGGS
Practice Address - State:ID
Practice Address - Zip Code:83422-5125
Practice Address - Country:US
Practice Address - Phone:208-920-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1335171100000X
ID316171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist