Provider Demographics
NPI:1558843037
Name:PEARSON, LORENZO D II (CERT HAIR LOSS SPECI)
Entity Type:Individual
Prefix:MR
First Name:LORENZO
Middle Name:D
Last Name:PEARSON
Suffix:II
Gender:M
Credentials:CERT HAIR LOSS SPECI
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17572 SHAFTSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-3544
Mailing Address - Country:US
Mailing Address - Phone:313-313-6177
Mailing Address - Fax:
Practice Address - Street 1:13711 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-4153
Practice Address - Country:US
Practice Address - Phone:313-633-6177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management