Provider Demographics
NPI:1447210141
Name:LONNING, JAMES BRIAN (ATC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BRIAN
Last Name:LONNING
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 120TH ST
Mailing Address - Street 2:
Mailing Address - City:BODE
Mailing Address - State:IA
Mailing Address - Zip Code:50519-8533
Mailing Address - Country:US
Mailing Address - Phone:515-379-1284
Mailing Address - Fax:
Practice Address - Street 1:1200 1ST AVE E
Practice Address - Street 2:SUITE C
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4342
Practice Address - Country:US
Practice Address - Phone:712-262-7511
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA952255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer