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General NPI Number Information
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NPI Number | 1215040944
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Entity Type | Individual
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Provider Name | JAN CLENNEY LENZ O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 1110 S. MONTGOMERY AVE TENNESSEE RIVER EYE CLINIC
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City | SHEFFIELD
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State | AL
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Zip | 35660
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Country | US
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Telephone | 256-320-2020
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Fax | 256-381-7754
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Provider Business Mailing Address
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Address Line | 1110 S. MONTGOMERY AVE TENNESSEE RIVER EYE CLINIC
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City | SHEFFIELD
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State | AL
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Zip | 35660
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Country | US
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Telephone | 256-381-2020
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Fax | 256-381-7754
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S704TA052
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License Number State | AL
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