Provider Demographics
NPI:1790454312
Name:LAUREN LOBERT PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:LAUREN LOBERT PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:HANSCHE
Authorized Official - Last Name:LOBERT FRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:810-534-7004
Mailing Address - Street 1:603 W GRAND RIVER AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-2390
Mailing Address - Country:US
Mailing Address - Phone:810-534-7004
Mailing Address - Fax:810-775-1046
Practice Address - Street 1:23955 FREEWAY PARK DR STE C
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2817
Practice Address - Country:US
Practice Address - Phone:248-534-4400
Practice Address - Fax:248-479-9861
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAUREN LOBERT PHYSICAL THERAPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty