Provider Demographics
NPI:1518457944
Name:LANTIMO-VETTER, DORINE (DO)
Entity type:Individual
Prefix:
First Name:DORINE
Middle Name:
Last Name:LANTIMO-VETTER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 HIGHLANDS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7681
Mailing Address - Country:US
Mailing Address - Phone:717-627-4088
Mailing Address - Fax:717-627-4089
Practice Address - Street 1:1535 HIGHLANDS DR STE 100
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7681
Practice Address - Country:US
Practice Address - Phone:717-627-4088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOS022345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program