Wallace, Lori
Wallace, Lori is an individual health care provider with primary practice located at 6800 Nw 39Th Expy , Bethany OK 73008-2513. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Wallace, Lori can be contacted via phone (405) 440-9866.Contact Information
Primary practice address
6800 Nw 39Th Expy
Bethany OK 73008-2513
Phone: (405) 440-9866
Fax: (405) 782-0024
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | 1399 | Oklahoma |
Profile Details
| NPI number | 1689991366 |
|---|---|
| LBN Legal business name | Wallace, Lori |
| Credentials | Registered Physical Therapist (RPT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 21st, 2010 |
| Last updated | Oct 19th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689991366 | NPPES |
| Oklahoma | MEDICAID | 200284400A |
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