MEDICARE: MISS JULIE ANN LORENC DPT

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	225100000X	Physical Therapist	PT018063	PA

General Provider Information

NPI Number	:	1811000508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JULIE ANN LORENC DPT

Provider Business Mailing Address
First Line	:	78 2ND AVE
Second Line	:
City	:	COLLEGEVILLE
State	:	PA
Zip	:	19426-3646
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	78 2ND AVE
Second Line	:
City	:	COLLEGEVILLE
State	:	PA
Zip	:	19426-3646
Country	:	US
Telephone Number	:	610-489-7703
Fax Number	:

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

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	07/08/2007

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