Provider Demographics
NPI:1265699631
Name:LORENZEN, SHELLEY ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:ANNE
Last Name:LORENZEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 NUECES ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1719
Mailing Address - Country:US
Mailing Address - Phone:512-479-7878
Mailing Address - Fax:
Practice Address - Street 1:1205 NUECES ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1719
Practice Address - Country:US
Practice Address - Phone:512-479-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor