Provider Demographics
NPI:1326011156
Name:MEYER, LORI BETH (ATC, LAT)
Entity Type:Individual
Prefix:MISS
First Name:LORI
Middle Name:BETH
Last Name:MEYER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47660-8963
Mailing Address - Country:US
Mailing Address - Phone:812-749-1513
Mailing Address - Fax:812-749-1589
Practice Address - Street 1:138 N LUCRETIA ST
Practice Address - Street 2:
Practice Address - City:OAKLAND CITY
Practice Address - State:IN
Practice Address - Zip Code:47660-1038
Practice Address - Country:US
Practice Address - Phone:812-749-1513
Practice Address - Fax:812-749-1589
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001031A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer