Provider Demographics
NPI:1225350424
Name:SNOW, LORRAINE A (PT)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:A
Last Name:SNOW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:A
Other - Last Name:LACOPPOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:12356 W NEVADA PL
Mailing Address - Street 2:#305
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3231
Mailing Address - Country:US
Mailing Address - Phone:516-661-5849
Mailing Address - Fax:
Practice Address - Street 1:12356 W NEVADA PL
Practice Address - Street 2:#305
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-3231
Practice Address - Country:US
Practice Address - Phone:516-661-5849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL-10647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist