Provider Demographics
NPI:1760880090
Name:WEINER, LORI ELLEN (PT)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ELLEN
Last Name:WEINER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:ELLEN
Other - Last Name:SIMONDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1000 W ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4800
Mailing Address - Country:US
Mailing Address - Phone:828-693-3388
Mailing Address - Fax:
Practice Address - Street 1:44 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-4629
Practice Address - Country:US
Practice Address - Phone:561-901-8401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP10727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist