Healthcare Provider Details

I. General information

NPI: 1073823126
Provider Name (Legal Business Name): LORENZO B REED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 W CHEYENNE AVE STE 10
N LAS VEGAS NV
89030-3931
US

IV. Provider business mailing address

7116 MANZANARES DR.
N. LAS VEGAS NV
89084
US

V. Phone/Fax

Practice location:
  • Phone: 702-290-9398
  • Fax: 702-664-6230
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: