Provider Demographics
NPI:1376087130
Name:HANN, LORI ELAINE (ATC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ELAINE
Last Name:HANN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 SWEET VALLEY LN
Mailing Address - Street 2:APT B3
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-8320
Mailing Address - Country:US
Mailing Address - Phone:765-491-0657
Mailing Address - Fax:
Practice Address - Street 1:3700 SWEET VALLEY LN
Practice Address - Street 2:APT B3
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-8320
Practice Address - Country:US
Practice Address - Phone:765-491-0657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer