Provider Demographics
NPI:1144535071
Name:WILLIFORD, LORA REMONIA (RPT)
Entity type:Individual
Prefix:MRS
First Name:LORA
Middle Name:REMONIA
Last Name:WILLIFORD
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MRS
Other - First Name:LORA
Other - Middle Name:REMONIA
Other - Last Name:WILLIFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PRT
Mailing Address - Street 1:9746 NORTHFORK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8333
Mailing Address - Country:US
Mailing Address - Phone:615-776-3773
Mailing Address - Fax:
Practice Address - Street 1:8044 COLEY DAVIS RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2310
Practice Address - Country:US
Practice Address - Phone:615-646-4466
Practice Address - Fax:615-673-1273
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist