Provider Demographics
NPI:1821305756
Name:GARCIA, LORI J (CPTA)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:J
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 SW PLASS AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-2747
Mailing Address - Country:US
Mailing Address - Phone:785-608-5114
Mailing Address - Fax:
Practice Address - Street 1:1821 SE 21ST ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66607-1437
Practice Address - Country:US
Practice Address - Phone:785-234-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00633314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility