Provider Demographics
NPI:1306618095
Name:LORR, JAMES H (LAC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:LORR
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S BROADWAY AVE STE 155-A
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-3449
Mailing Address - Country:US
Mailing Address - Phone:217-344-9118
Mailing Address - Fax:
Practice Address - Street 1:300 S BROADWAY AVE STE 155-A
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-3449
Practice Address - Country:US
Practice Address - Phone:217-344-9118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001019171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty