MEDICARE: WILLIAM ANTHONY LORO PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305207291	VA

General Provider Information

NPI Number	:	1568408169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ANTHONY LORO PT

Provider Business Mailing Address
First Line	:	3920 SPRINGFIELD RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-4119
Country	:	US
Telephone Number	:	804-747-7472
Fax Number	:	804-747-7441

Provider Business Practice Location Address
First Line	:	3920 SPRINGFIELD RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-4119
Country	:	US
Telephone Number	:	804-747-7472
Fax Number	:	804-747-7441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	10/30/2014

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