Provider Demographics
NPI:1477671733
Name:DUNCAN, LORI KRISTINE (DPT, MTC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:KRISTINE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:DPT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12585 WINONA CT
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-5773
Mailing Address - Country:US
Mailing Address - Phone:303-880-2883
Mailing Address - Fax:
Practice Address - Street 1:12585 WINONA CT
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-5773
Practice Address - Country:US
Practice Address - Phone:303-880-2883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9505225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1750337358OtherNPI FACILITY NUMBER
102072963OtherOWCP IDENTIFATION
1750337358OtherNPI FACILITY NUMBER