Provider Demographics
NPI:1790300325
Name:LOZON, ANN MARIE (CCHT)
Entity Type:Individual
Prefix:MISS
First Name:ANN
Middle Name:MARIE
Last Name:LOZON
Suffix:
Gender:F
Credentials:CCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6064 N SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2861
Mailing Address - Country:US
Mailing Address - Phone:734-207-6219
Mailing Address - Fax:
Practice Address - Street 1:6064 N SHELDON RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2861
Practice Address - Country:US
Practice Address - Phone:734-207-6219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICCHT2472R0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal Dialysis