Provider Demographics
NPI:1275103335
Name:LIEVRE, LORI L (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:L
Last Name:LIEVRE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 STONERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2874
Mailing Address - Country:US
Mailing Address - Phone:540-535-7255
Mailing Address - Fax:
Practice Address - Street 1:401 CAMPUS BLVD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2800
Practice Address - Country:US
Practice Address - Phone:540-536-3011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist