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Individual

LORIE S DORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
923 ELIZA ST, GREEN BAY, WI 54301-3234
(920) 965-4800
(920) 431-7024
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
411-156
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41144000
WI
01
507105
MEDICARE PTAN
WI
Enumeration date
02/15/2007
Last updated
02/25/2016
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