Provider Demographics
NPI:1083759740
Name:LORENZ, DANIEL STEVEN (MS, PT, ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:STEVEN
Last Name:LORENZ
Suffix:
Gender:M
Credentials:MS, PT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15200 W 123RD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1081
Mailing Address - Country:US
Mailing Address - Phone:913-829-4439
Mailing Address - Fax:
Practice Address - Street 1:294 NE TUDOR RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5696
Practice Address - Country:US
Practice Address - Phone:816-554-6003
Practice Address - Fax:816-554-6013
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005038204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOR710000Medicare ID - Type UnspecifiedPHYSICAL THERAPY