Provider Demographics
NPI:1063489607
Name:LORENTZ, CHRISTINA MARIE (PT)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:LORENTZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5828 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55807-1221
Mailing Address - Country:US
Mailing Address - Phone:218-310-3663
Mailing Address - Fax:
Practice Address - Street 1:925 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2238
Practice Address - Country:US
Practice Address - Phone:218-728-1100
Practice Address - Fax:218-728-1316
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist