Provider Demographics
NPI:1962971069
Name:LEHR, KORI
Entity type:Individual
Prefix:
First Name:KORI
Middle Name:
Last Name:LEHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KORI
Other - Middle Name:
Other - Last Name:LEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA, CBIS
Mailing Address - Street 1:1766 DARTMOOR DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8137
Mailing Address - Country:US
Mailing Address - Phone:248-917-6589
Mailing Address - Fax:
Practice Address - Street 1:31215 NOVI RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-4515
Practice Address - Country:US
Practice Address - Phone:248-624-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502004758225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant