MEDICARE: LORI HOGENKAMP L.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	31-0186140	OH

General Provider Information

NPI Number	:	1700046562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI HOGENKAMP L.M.T.

Provider Business Mailing Address
First Line	:	6961 THORNDIKE RD APT 1
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-3728
Country	:	US
Telephone Number	:	513-313-1076
Fax Number	:

Provider Business Practice Location Address
First Line	:	7798 UNIVERSITY CT
Second Line	:	SUITE A
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-7745
Country	:	US
Telephone Number	:	513-777-4577
Fax Number	:	513-420-9075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2008
Last Update Date	:	06/13/2008

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