Provider Demographics
NPI:1710165899
Name:SYMONDS, LORNA MAE (PTA)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:MAE
Last Name:SYMONDS
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 1:205 N NORTH ST
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MI
Mailing Address - Zip Code:49078-1018
Mailing Address - Country:US
Mailing Address - Phone:269-788-5803
Mailing Address - Fax:
Practice Address - Street 1:205 N NORTH ST
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MI
Practice Address - Zip Code:49078-1018
Practice Address - Country:US
Practice Address - Phone:269-788-5803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant