Healthcare Provider Details

I. General information

NPI: 1992835177
Provider Name (Legal Business Name): JOANNE LOZY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNE CHAMBERLAND LMT

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 ATWOOD AVE
JOHNSTON RI
02919-4936
US

IV. Provider business mailing address

1308 ATWOOD AVE
JOHNSTON RI
02919-4936
US

V. Phone/Fax

Practice location:
  • Phone: 401-237-7515
  • Fax:
Mailing address:
  • Phone: 401-237-7515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT0511
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: