Provider Demographics
NPI:1699734020
Name:UNRUH, LORI LYNN (DPT)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LYNN
Last Name:UNRUH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:LORI
Other - Middle Name:LYNN
Other - Last Name:VEDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2618 N SAGINAW RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-3001
Mailing Address - Country:US
Mailing Address - Phone:989-837-1529
Mailing Address - Fax:989-837-2499
Practice Address - Street 1:2618 N SAGINAW RD
Practice Address - Street 2:SUITE A
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-3001
Practice Address - Country:US
Practice Address - Phone:989-837-1529
Practice Address - Fax:989-837-2499
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012449225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist