Provider Demographics
NPI:1821224817
Name:PICKERING, LORI ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:PICKERING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:HELLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:839 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-2559
Mailing Address - Country:US
Mailing Address - Phone:330-225-4182
Mailing Address - Fax:330-225-4879
Practice Address - Street 1:839 PEARL RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-2559
Practice Address - Country:US
Practice Address - Phone:330-225-4182
Practice Address - Fax:330-225-4879
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist