Provider Demographics
NPI:1699486084
Name:CARPENTER, LONZO HOY
Entity type:Individual
Prefix:
First Name:LONZO
Middle Name:HOY
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 HARRISON AVE STE A2
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-4514
Mailing Address - Country:US
Mailing Address - Phone:304-636-5195
Mailing Address - Fax:
Practice Address - Street 1:1513 HARRISON AVE STE A2
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-4514
Practice Address - Country:US
Practice Address - Phone:304-636-5195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant