Provider Demographics
NPI:1386617660
Name:PIRES, LORI (PT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:PIRES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134
Mailing Address - Country:US
Mailing Address - Phone:617-623-6300
Mailing Address - Fax:617-623-4224
Practice Address - Street 1:14 MCGRATH HIGHWAY
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143
Practice Address - Country:US
Practice Address - Phone:617-623-6300
Practice Address - Fax:617-623-4224
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11557225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist