Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 16264 | MA |
N | 2251S0007X | Physical Therapist - Sports | 16264 | MA |
N | 2251X0800X | Physical Therapist - Orthopedic | 16264 | MA |
NPI | 1265405773 |
---|---|
Provider Name | Mrs. Lori Jean Feole Morin |
First Address | Brighton, MA 02135-1200 |
Second Address | Chestnut Hill, MA 02467-2116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 08/07/2007 |