Provider Demographics
NPI:1285648030
Name:LIVINGSTON, LORI A (PT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:LUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1677
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 TRINITY DR E
Practice Address - Street 2:SUITE 110
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-8522
Practice Address - Country:US
Practice Address - Phone:717-432-7719
Practice Address - Fax:717-432-7531
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT016421OtherPT