Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 7521 | AZ |
NPI | 1437212180 |
---|---|
Provider Name | Dr. Lawrence Anthony Sanchez |
First Address | Tempe, AZ 85282-7381 |
Second Address | Tempe, AZ 85282-7381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2006 |
Last Update Date | 31/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AZ 0198590 | BLUE CROSS ID (01) | AZ |