Provider Demographics
NPI:1477785723
Name:FEAGIN, LORI WOMACK (PT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:WOMACK
Last Name:FEAGIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 LEYLAND DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8496
Mailing Address - Country:US
Mailing Address - Phone:843-206-6101
Mailing Address - Fax:
Practice Address - Street 1:2100 TWIN CHURCH RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-8222
Practice Address - Country:US
Practice Address - Phone:843-292-8936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist