Provider Demographics
NPI:1821180787
Name:GALVIN, LORI ANN (PT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:GALVIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3902
Mailing Address - Country:US
Mailing Address - Phone:724-463-7478
Mailing Address - Fax:724-463-0931
Practice Address - Street 1:333 HARVEY AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1993
Practice Address - Country:US
Practice Address - Phone:724-837-3401
Practice Address - Fax:724-837-3439
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011320L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7588745OtherAETNA
PA418892OtherHEALTH AMER/HEALTH ASSUR.
PAGA1809784OtherHIGHMARK BLUE SHIELD
PA396749Medicare ID - Type UnspecifiedMEDICARE