Provider Demographics
NPI:1427015403
Name:KIBBY, LORI LYNN (ATC COTA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:LYNN
Last Name:KIBBY
Suffix:
Gender:F
Credentials:ATC COTA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:LYNN
Other - Last Name:ARNBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-0461
Mailing Address - Country:US
Mailing Address - Phone:515-382-3366
Mailing Address - Fax:515-382-1576
Practice Address - Street 1:610 10TH ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220
Practice Address - Country:US
Practice Address - Phone:515-465-7672
Practice Address - Fax:515-465-7655
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00119224Z00000X
IA001912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer