Provider Demographics
NPI:1194465690
Name:THROCKMORTON, LORI (HHA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:THROCKMORTON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EDENDALE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-8865
Mailing Address - Country:US
Mailing Address - Phone:740-456-5178
Mailing Address - Fax:
Practice Address - Street 1:201 EDENDALE RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-8865
Practice Address - Country:US
Practice Address - Phone:740-456-5178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant