Provider Demographics
NPI:1366787624
Name:LORENZO, ANTHONY JAMES (LAC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JAMES
Last Name:LORENZO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36001 EUCLID AVE
Mailing Address - Street 2:SUITE A-6
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4643
Mailing Address - Country:US
Mailing Address - Phone:440-942-3100
Mailing Address - Fax:
Practice Address - Street 1:36001 EUCLID AVE
Practice Address - Street 2:SUITE A-6
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4643
Practice Address - Country:US
Practice Address - Phone:440-942-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000247171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist