Provider Demographics
NPI:1316362932
Name:LOHMAN, KEITH
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:LOHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5424 KEYES DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49004-1529
Mailing Address - Country:US
Mailing Address - Phone:269-382-3840
Mailing Address - Fax:269-382-3840
Practice Address - Street 1:6276 N RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49004-9601
Practice Address - Country:US
Practice Address - Phone:269-382-3840
Practice Address - Fax:269-382-3840
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral