Provider Demographics
NPI:1467048660
Name:MOTE, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:MOTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6467 TERRACE VIEW CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3600
Mailing Address - Country:US
Mailing Address - Phone:937-903-7206
Mailing Address - Fax:
Practice Address - Street 1:6467 TERRACE VIEW CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-3600
Practice Address - Country:US
Practice Address - Phone:937-903-7206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No347C00000XTransportation ServicesPrivate Vehicle