Provider Demographics
NPI:1821310616
Name:BOYER, LORI
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:
Last Name:BOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 ZUNI DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81503-2822
Mailing Address - Country:US
Mailing Address - Phone:281-462-1285
Mailing Address - Fax:281-462-1554
Practice Address - Street 1:311 ZUNI DR
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81503-2822
Practice Address - Country:US
Practice Address - Phone:281-462-1285
Practice Address - Fax:281-462-1554
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CNIM 881246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic