Provider Demographics
NPI:1700046562
Name:HOGENKAMP, LORI (LMT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:HOGENKAMP
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6961 THORNDIKE RD APT 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-3728
Mailing Address - Country:US
Mailing Address - Phone:513-313-1076
Mailing Address - Fax:
Practice Address - Street 1:7798 UNIVERSITY CT
Practice Address - Street 2:SUITE A
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-7745
Practice Address - Country:US
Practice Address - Phone:513-777-4577
Practice Address - Fax:513-420-9075
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31-0186140111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor