Provider Demographics
NPI:1053769166
Name:LORENZO HOLISTIC HEALTH CENTER
Entity type:Organization
Organization Name:LORENZO HOLISTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:440-942-3100
Mailing Address - Street 1:3681 SOUTH GREEN ROAD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:440-942-3100
Mailing Address - Fax:
Practice Address - Street 1:3681 SOUTH GREEN ROAD
Practice Address - Street 2:SUITE 406
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:440-942-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000247171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty