Provider Demographics
NPI:1275641201
Name:VON ALTEN, LORI M (PT, ATC-L, CSCI, CPI)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:M
Last Name:VON ALTEN
Suffix:
Gender:F
Credentials:PT, ATC-L, CSCI, CPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 KITCHNER CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1829
Mailing Address - Country:US
Mailing Address - Phone:919-308-7465
Mailing Address - Fax:
Practice Address - Street 1:3633 HARDEN RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-3369
Practice Address - Country:US
Practice Address - Phone:919-789-4459
Practice Address - Fax:919-789-8342
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist