Individual
MRS. TERESA ROSE LOZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1428 W MEYER RD, WENTZVILLE, MO 63385-3499
(636) 887-3660
(636) 887-3661
Mailing address
607 DEWEY AVE NW, STE 300, GRAND RAPIDS, MI 49504-7335
(616) 356-5000
(616) 356-5001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2015027177
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13660955
CAQH
MO
Enumeration date
08/28/2015
Last updated
05/29/2016
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