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NPI Code Detail

MEDICARE: LORA HELEN DEVORE PT

MEDICARE: LORA HELEN DEVORE 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
1225100000XPhysical Therapist2030WA
22251G0304XGeriatric Physical Therapist2030WA

General Provider Information

NPI Number : 1730320045
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORA HELEN DEVORE PT
Provider Business Mailing Address
First Line : 1355 W MAIN ST
Second Line :
City : MONROE
State : WA
Zip : 98272-2022
Country : US
Telephone Number : 360-794-4011
Fax Number :
Provider Business Practice Location Address
First Line : 1355 W MAIN ST
Second Line :
City : MONROE
State : WA
Zip : 98272-2022
Country : US
Telephone Number : 360-794-4011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2009
Last Update Date : 03/16/2009

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Directions to “ LORA HELEN DEVORE PT” Practice Location

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