Healthcare Provider Details

I. General information

NPI: 1942882717
Provider Name (Legal Business Name): LORI YEAMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12281 MONETA RD STE B
MONETA VA
24121-6402
US

IV. Provider business mailing address

20347 TIMBERLAKE RD STE B
LYNCHBURG VA
24502-7352
US

V. Phone/Fax

Practice location:
  • Phone: 540-296-3203
  • Fax: 434-509-1695
Mailing address:
  • Phone: 540-296-3203
  • Fax: 434-509-1695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305214083
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: