Provider Demographics
NPI:1629276399
Name:FERRAR - MOOREFIELD, LORA JEAN (LPT, MST)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:JEAN
Last Name:FERRAR - MOOREFIELD
Suffix:
Gender:F
Credentials:LPT, MST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9847 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NEW LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45345-9323
Mailing Address - Country:US
Mailing Address - Phone:937-835-3682
Mailing Address - Fax:937-835-3683
Practice Address - Street 1:9847 MILE RD
Practice Address - Street 2:
Practice Address - City:NEW LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45345-9323
Practice Address - Country:US
Practice Address - Phone:937-835-3682
Practice Address - Fax:937-835-3683
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 008336225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist