Provider Demographics
NPI:1700861515
Name:LORENZ, PATRICK J (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
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 1:101 E BLACKHAWK AVE BOX 206
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU CHEIN
Mailing Address - State:WI
Mailing Address - Zip Code:53821
Mailing Address - Country:US
Mailing Address - Phone:608-326-2737
Mailing Address - Fax:
Practice Address - Street 1:101 E BLACKHAWK AVE # 206
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821-1528
Practice Address - Country:US
Practice Address - Phone:608-326-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38783600Medicaid
WI70460Medicare ID - Type Unspecified
WI38783600Medicaid