Healthcare Provider Details

I. General information

NPI: 1528096740
Provider Name (Legal Business Name): BRIAN KENNETH LORANGER D.C., D.A.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W COLUMBIA AVE
BELLEVILLE MI
48111-2719
US

IV. Provider business mailing address

125 W COLUMBIA AVE
BELLEVILLE MI
48111-2719
US

V. Phone/Fax

Practice location:
  • Phone: 734-697-4244
  • Fax: 734-697-8102
Mailing address:
  • Phone: 734-697-4244
  • Fax: 734-697-8102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberBL005254
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: