Provider Demographics
NPI:1801285291
Name:LAROCHE, LORI LYNN (DPT)
Entity type:Individual
Prefix:
First Name:LORI LYNN
Middle Name:
Last Name:LAROCHE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 ORONOQUE LN
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1379
Mailing Address - Country:US
Mailing Address - Phone:203-870-2022
Mailing Address - Fax:
Practice Address - Street 1:999 ORONOQUE LN
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-1379
Practice Address - Country:US
Practice Address - Phone:203-870-2022
Practice Address - Fax:203-386-1144
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist