Provider Demographics
NPI:1467649772
Name:LUMBREZER, ANN (RN, LMT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:LUMBREZER
Suffix:
Gender:F
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 SYLVANIA AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3933
Mailing Address - Country:US
Mailing Address - Phone:419-344-6157
Mailing Address - Fax:
Practice Address - Street 1:6600 SYLVANIA AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3933
Practice Address - Country:US
Practice Address - Phone:419-344-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.008763172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist