Provider Demographics
NPI:1871758672
Name:TIMMRECK, LORI LYNN (ORTHOTIC FITTER)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:LYNN
Last Name:TIMMRECK
Suffix:
Gender:F
Credentials:ORTHOTIC FITTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 E SILVER SPRINGS BLVD
Mailing Address - Street 2:SUITE#505
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-3228
Mailing Address - Country:US
Mailing Address - Phone:352-236-2599
Mailing Address - Fax:352-236-2293
Practice Address - Street 1:4901 E SILVER SPRINGS BLVD
Practice Address - Street 2:SUITE#505
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-3228
Practice Address - Country:US
Practice Address - Phone:352-236-2599
Practice Address - Fax:352-236-2293
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLORF128225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter