Provider Demographics
NPI:1518665124
Name:LONZ, JENNY (DUAL LICENSED OPT)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:LONZ
Suffix:
Gender:F
Credentials:DUAL LICENSED OPT
Other - Prefix:MRS
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:LONZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DUAL LICENSED OPT
Mailing Address - Street 1:340 WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-9104
Mailing Address - Country:US
Mailing Address - Phone:419-660-1209
Mailing Address - Fax:419-660-1230
Practice Address - Street 1:340 WESTWIND DR
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-9104
Practice Address - Country:US
Practice Address - Phone:419-660-1209
Practice Address - Fax:419-660-1230
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1800X
OHOP.9861SC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician