Provider Demographics
NPI:1992916746
Name:KUHN, LORI M (PTA)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:M
Last Name:KUHN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W7480 COUNTY ROAD V
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:WI
Mailing Address - Zip Code:53011-1231
Mailing Address - Country:US
Mailing Address - Phone:920-528-7738
Mailing Address - Fax:
Practice Address - Street 1:916 E CLIFFORD ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:WI
Practice Address - Zip Code:53073-2438
Practice Address - Country:US
Practice Address - Phone:920-892-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI832-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant