Provider Demographics
NPI:1790369122
Name:EMBERS, LORRA T (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:LORRA
Middle Name:T
Last Name:EMBERS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8835 W 303RD
Mailing Address - Street 2:P.O. BOX 1166
Mailing Address - City:LOUISBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66053
Mailing Address - Country:US
Mailing Address - Phone:913-636-5848
Mailing Address - Fax:
Practice Address - Street 1:8835 W 303RD ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:KS
Practice Address - Zip Code:66053-6199
Practice Address - Country:US
Practice Address - Phone:913-709-6836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00675225100000X
MOR0351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist