Provider Demographics
NPI:1114056678
Name:LORENZ, NATHAN ELLIS (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ELLIS
Last Name:LORENZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 N HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6785
Mailing Address - Country:US
Mailing Address - Phone:614-475-1900
Mailing Address - Fax:614-475-1920
Practice Address - Street 1:1251 N HAMILTON RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6785
Practice Address - Country:US
Practice Address - Phone:614-475-1900
Practice Address - Fax:614-475-1920
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor