Provider Demographics
NPI:1891000139
Name:MCCARY, LOREE (ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:LOREE
Middle Name:
Last Name:MCCARY
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13010
Mailing Address - Street 2:SFA STATION
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75962-0001
Mailing Address - Country:US
Mailing Address - Phone:936-468-4550
Mailing Address - Fax:936-468-4052
Practice Address - Street 1:1936 NORTH ST
Practice Address - Street 2:SFA SPORTS MEDICINE CLINIC
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-3940
Practice Address - Country:US
Practice Address - Phone:936-468-4550
Practice Address - Fax:936-468-4052
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT1184208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation