Provider Demographics
NPI:1710189170
Name:LORENZON, MARJORIE ANN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:PROF
First Name:MARJORIE
Middle Name:ANN
Last Name:LORENZON
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14246 WILLIAMSBURG ST
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7657
Mailing Address - Country:US
Mailing Address - Phone:173-428-1160
Mailing Address - Fax:
Practice Address - Street 1:17084 FORT ST
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-6626
Practice Address - Country:US
Practice Address - Phone:131-330-0367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist