Provider Demographics
NPI:1245798511
Name:NORTHVIEW MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:NORTHVIEW MEDICAL CLINIC LLC
Other - Org Name:NORTHVIEW MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAVANNA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:307-632-3399
Mailing Address - Street 1:7356 STOCKMAN ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-6006
Mailing Address - Country:US
Mailing Address - Phone:307-632-3399
Mailing Address - Fax:
Practice Address - Street 1:7356 STOCKMAN ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-6006
Practice Address - Country:US
Practice Address - Phone:307-287-8426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty