Provider Demographics
NPI:1740471515
Name:LAZY LION LLC
Entity type:Organization
Organization Name:LAZY LION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZIMNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-461-8662
Mailing Address - Street 1:4049 DON FOX CIR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3469
Mailing Address - Country:US
Mailing Address - Phone:970-461-8662
Mailing Address - Fax:
Practice Address - Street 1:910 E EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3922
Practice Address - Country:US
Practice Address - Phone:970-461-8662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN101628800Medicaid
MN350003360Medicare UPIN