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General NPI Number Information
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NPI Number | 1710295837
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Entity Type | Organization
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Legal Business Name | LORENZ CHIROPRACTIC OFFICE LLC
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 101 E BLACKHAWK AVE
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City | PRAIRIE DU CHIEN
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State | WI
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Zip | 53821-1528
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Country | US
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Telephone | 608-326-2737
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Fax | 608-326-4735
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Provider Business Mailing Address
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Address Line | 101 E BLACKHAWK AVE PO BOX 206
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City | PRAIRIE DU CHIEN
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State | WI
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Zip | 53821-1528
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Country | US
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Telephone | 608-326-2737
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Fax | 608-326-4735
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Authorized Official
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Title or Position | CA
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Name | MRS. KARLA K COON
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Credential |
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Telephone | 608-375-2411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1898
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License Number State | WI
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