Provider Demographics
NPI:1649618679
Name:LORD, DAVID RICHARD (PT, DSC, ECS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:RICHARD
Last Name:LORD
Suffix:
Gender:M
Credentials:PT, DSC, ECS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 FOREST LANE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323
Mailing Address - Country:US
Mailing Address - Phone:814-677-7022
Mailing Address - Fax:814-677-7049
Practice Address - Street 1:300 STATE STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507
Practice Address - Country:US
Practice Address - Phone:814-454-5251
Practice Address - Fax:814-459-1884
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002366L2251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical