Healthcare Provider Details

I. General information

NPI: 1841847910
Provider Name (Legal Business Name): LORI GEIGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N 26TH ST STE 219
ESCANABA MI
49829-2500
US

IV. Provider business mailing address

6542 MARBLE 23.25 LN
GLADSTONE MI
49837-2768
US

V. Phone/Fax

Practice location:
  • Phone: 906-399-4994
  • Fax:
Mailing address:
  • Phone: 906-428-4361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704168517
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2015
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: