Provider Demographics
NPI:1770711194
Name:LANGTON, LORI JANE (DPT, CLT)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:JANE
Last Name:LANGTON
Suffix:
Gender:F
Credentials:DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 S TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-1611
Mailing Address - Country:US
Mailing Address - Phone:734-240-1950
Mailing Address - Fax:734-240-1955
Practice Address - Street 1:407 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-1611
Practice Address - Country:US
Practice Address - Phone:734-240-1950
Practice Address - Fax:734-240-1955
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236836Medicare Oscar/Certification