Provider Demographics
NPI:1821454364
Name:SCHROEDER, LORI ANN (MMP,LMT,NMT)
Entity Type:Individual
Prefix:MISS
First Name:LORI
Middle Name:ANN
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:MMP,LMT,NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4456 CENTER POINT RD
Mailing Address - Street 2:
Mailing Address - City:PINSON
Mailing Address - State:AL
Mailing Address - Zip Code:35126-3296
Mailing Address - Country:US
Mailing Address - Phone:205-201-3919
Mailing Address - Fax:
Practice Address - Street 1:4456 CENTER POINT RD
Practice Address - Street 2:
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-3296
Practice Address - Country:US
Practice Address - Phone:205-201-3919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3973225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist