Provider Demographics
NPI:1669028890
Name:LIVE WITH EASE WELLNESS LLC
Entity Type:Organization
Organization Name:LIVE WITH EASE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:MAC LAC
Authorized Official - Phone:410-870-5507
Mailing Address - Street 1:600 WYNDHURST AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2435
Mailing Address - Country:US
Mailing Address - Phone:410-870-5507
Mailing Address - Fax:
Practice Address - Street 1:600 WYNDHURST AVE STE 235
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2435
Practice Address - Country:US
Practice Address - Phone:410-870-5507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty