Lorenz, Jack Ellis
Lorenz, Jack Ellis is an individual health care provider with primary practice located at 1770 Jefferson Ave , Defiance OH 43512. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Lorenz, Jack Ellis can be contacted via phone (419) 782-2250.Contact Information
Primary practice address
1770 Jefferson Ave
Defiance OH 43512
Phone: (419) 782-2250
Fax: (419) 784-2347
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 676 | Ohio |
Profile Details
| NPI number | 1083723613 |
|---|---|
| LBN Legal business name | Lorenz, Jack Ellis |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Dec 15th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083723613 | NPPES |
| Other | 000000119614 | ANTHEM | |
| MEDICAID | 0340885 | ANTHEM |
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