Provider Demographics
NPI:1053864876
Name:RAY, LORI (MED, ATC)
Entity Type:Individual
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First Name:LORI
Middle Name:
Last Name:RAY
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Gender:F
Credentials:MED, ATC
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Mailing Address - Street 1:4046 ARIZONA ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1778
Mailing Address - Country:US
Mailing Address - Phone:619-388-3750
Mailing Address - Fax:619-388-3651
Practice Address - Street 1:1313 PARK BLVD
Practice Address - Street 2:SAN DIEGO CITY COLLEGE
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101
Practice Address - Country:US
Practice Address - Phone:619-388-3750
Practice Address - Fax:619-388-3651
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer