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General NPI Number Information
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NPI Number | 1396656435
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Entity Type | Individual
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Provider Name | JESSICA LORENZ PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 700 GENEVA PKWY N
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City | LAKE GENEVA
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State | WI
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Zip | 53147-4594
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Country | US
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Telephone | 262-249-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 776 TRUMAN ST
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City | OREGON
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State | WI
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Zip | 53575-2847
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Country | US
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Telephone | 608-220-8811
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 17900-24
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License Number State | WI
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