Provider Demographics
NPI:1669607586
Name:HELLENBRAND, LORI K (WRMT, NCTMB)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:K
Last Name:HELLENBRAND
Suffix:
Gender:F
Credentials:WRMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 HILLEBRAND DR
Mailing Address - Street 2:
Mailing Address - City:CROSS PLAINS
Mailing Address - State:WI
Mailing Address - Zip Code:53528-9121
Mailing Address - Country:US
Mailing Address - Phone:608-219-4850
Mailing Address - Fax:
Practice Address - Street 1:2034 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CROSS PLAINS
Practice Address - State:WI
Practice Address - Zip Code:53528-8855
Practice Address - Country:US
Practice Address - Phone:608-219-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40-046225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist