Basic Information
| Provider Information | |||||||||
| NPI: | 1740903764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LORENGER | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4712 OAK CREEK DR | ||||||||
| Address2: | |||||||||
| City: | FORT WAYNE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 468354283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2602550823 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9200 HARRIS CORNERS PKWY STE K | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282693782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043429011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2022 | ||||||||
| LastUpdateDate: | 09/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | P21662 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.