Provider Demographics
NPI:1508981028
Name:GEMMELL, LORI KATHRYN (PTA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:KATHRYN
Last Name:GEMMELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 STREETER HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03466-3418
Mailing Address - Country:US
Mailing Address - Phone:603-357-3800
Mailing Address - Fax:
Practice Address - Street 1:677 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1702
Practice Address - Country:US
Practice Address - Phone:603-354-4158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH298225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant