Lorraine Michelle Torres Gozum, PHYSICAL THERAPIST
Individual provider Active NPI Physical Therapist · Tamuning, GU
NPI 1104542539 · NPPES record last updated Oct 18, 2022
Key facts
- NPI
- 1104542539
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-165 (GU)
- Practice address
- 548 S Marine Corps Dr
Tamuning, GU 96913-3539 - Phone
- (671) 646-5825
- NPI assigned
- Oct 18, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-165 | GU | MD | Physical Therapist |
| 3952 | NH | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3952 | NH | |
| Physical Therapist | 225100000X | PT-165 | GU | Yes |
Addresses
Primary practice location
548 S Marine Corps Dr
Tamuning, GU 96913-3539
Mailing address
PO Box 26919
Barrigada, GU 96921-6919
Other providers in Tamuning, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.