Provider Demographics
NPI:1275650574
Name:NOWC, LOREN DAVID (OTR)
Entity Type:Individual
Prefix:MR
First Name:LOREN
Middle Name:DAVID
Last Name:NOWC
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12220 PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-5228
Mailing Address - Country:US
Mailing Address - Phone:586-979-0433
Mailing Address - Fax:
Practice Address - Street 1:46591 ROMEO PLANK RD
Practice Address - Street 2:SUITE 115
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-5742
Practice Address - Country:US
Practice Address - Phone:586-226-6500
Practice Address - Fax:586-226-6505
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000706225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand