Provider Demographics
NPI:1952514309
Name:IRBY, LORI A (CST)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:IRBY
Suffix:
Gender:F
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 28TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1096
Mailing Address - Country:US
Mailing Address - Phone:303-449-2000
Mailing Address - Fax:303-449-9475
Practice Address - Street 1:1400 28TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1096
Practice Address - Country:US
Practice Address - Phone:303-449-2000
Practice Address - Fax:303-449-9475
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO96352246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist