Provider Demographics
NPI:1740903764
Name:LORENGER, ANTHONY J (PT)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:LORENGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4712 OAK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46835-4283
Mailing Address - Country:US
Mailing Address - Phone:260-255-0823
Mailing Address - Fax:
Practice Address - Street 1:9200 HARRIS CORNERS PKWY STE K
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-3782
Practice Address - Country:US
Practice Address - Phone:704-342-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP21662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist