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General NPI Number Information
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NPI Number | 1154136596
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Entity Type | Individual
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Provider Name | KATHERINE LORENS ATC, OTC
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Gender | Female
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 590 S WAKARA WAY
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City | SALT LAKE CITY
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State | UT
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Zip | 84108-1200
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Country | US
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Telephone | 801-213-4263
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Fax | 801-581-4110
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Provider Business Mailing Address
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Address Line | 827 S 1100 E
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-3708
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Country | US
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Telephone | 801-696-4935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 8059367-4810
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License Number State | UT
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