MEDICARE: LORI PLANCK CMT CNHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1215208772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI PLANCK CMT CNHP

Provider Business Mailing Address
First Line	:	3333 S PENNSYLVANIA AVE
Second Line	:	SUITE 102
City	:	LANSING
State	:	MI
Zip	:	48910-4795
Country	:	US
Telephone Number	:	517-881-1205
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 S PENNSYLVANIA AVE
Second Line	:	SUITE 102
City	:	LANSING
State	:	MI
Zip	:	48910-4795
Country	:	US
Telephone Number	:	517-881-1205
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2012
Last Update Date	:	01/14/2012

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