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General NPI Number Information
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NPI Number | 1497393359
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Entity Type | Organization
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Legal Business Name | BRETT LORENZ, OD, L.L.C.
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 510 W EMPIRE MALL
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City | SIOUX FALLS
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State | SD
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Zip | 57106-6509
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Country | US
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Telephone | 605-362-7944
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Fax | 605-362-7945
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Provider Business Mailing Address
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Address Line | 5316 S CHINOOK AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57108-2588
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Country | US
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Telephone | 605-380-5404
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | BRETT LORENZ
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Credential | OD
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Telephone | 605-380-5404
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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 |
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License Number State |
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