Provider Demographics
NPI:1902916422
Name:HARDIN, LORI VIGUERIE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:VIGUERIE
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:ELIZABETH
Other - Last Name:VIGUERIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1000 WATER ST SW APT 70
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2465
Mailing Address - Country:US
Mailing Address - Phone:703-909-4560
Mailing Address - Fax:
Practice Address - Street 1:6506 LOISDALE RD STE 300
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1815
Practice Address - Country:US
Practice Address - Phone:703-924-4100
Practice Address - Fax:703-922-0638
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204776225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist