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General NPI Number Information
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NPI Number | 1639299381
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Entity Type | Individual
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Provider Name | EILEEN A. LORSON LMT
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 720 EAST AVE SUITE 102
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City | ROCHESTER
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State | NY
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Zip | 14607-2192
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Country | US
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Telephone | 585-442-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 1885 DUBLIN RD
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City | PENFIELD
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State | NY
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Zip | 14526-1930
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Country | US
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Telephone | 585-377-0680
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 013095-1
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License Number State | NY
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