Provider Demographics
NPI:1972703155
Name:ROBBINS, LORI ANN (PTA)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:ROBBINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2850 S PINE BARREN RD
Mailing Address - Street 2:
Mailing Address - City:MC DAVID
Mailing Address - State:FL
Mailing Address - Zip Code:32568-2739
Mailing Address - Country:US
Mailing Address - Phone:318-230-1244
Mailing Address - Fax:
Practice Address - Street 1:2850 S PINE BARREN RD
Practice Address - Street 2:
Practice Address - City:MC DAVID
Practice Address - State:FL
Practice Address - Zip Code:32568-2739
Practice Address - Country:US
Practice Address - Phone:318-230-1244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20675225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant