Healthcare Provider Details

I. General information

NPI: 1619185774
Provider Name (Legal Business Name): LORENZ CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 CASS ST
LA CROSSE WI
54601-4508
US

IV. Provider business mailing address

432 CASS ST
LA CROSSE WI
54601-4508
US

V. Phone/Fax

Practice location:
  • Phone: 608-784-2227
  • Fax: 608-784-2439
Mailing address:
  • Phone: 608-784-2227
  • Fax: 608-784-2439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2648-012
License Number StateWI

VIII. Authorized Official

Name: LINDA LORENZ
Title or Position: PRESIDENT CHIROPRACTOR
Credential: D.C.
Phone: 608-784-2227