Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 273150 | OR |
N | 175F00000X | Naturopath | 1017 | OR |
NPI | 1134285760 |
---|---|
Provider Name | Dr. David Lawrence |
First Address | Corvallis, OR 97333-4067 |
Second Address | Corvallis, OR 97333-4067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 08/07/2007 |