Healthcare Provider Details

I. General information

NPI: 1447632989
Provider Name (Legal Business Name): LORI UHRIG P.T., ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2015
Last Update Date: 06/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 GATEWAY CORPORATE BLVD
COLUMBIA SC
29203-9740
US

IV. Provider business mailing address

127 CHALFONT LN
COLUMBIA SC
29229-7372
US

V. Phone/Fax

Practice location:
  • Phone: 803-227-8005
  • Fax:
Mailing address:
  • Phone: 803-447-0470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4131
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: