Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC011427 | PA |
N | 111NI0013X | Independent Medical Examiner | DC011427 | PA |
N | 207R00000X | Internist | DC011427 | PA |
N | 111NI0900X | Internist | DC011427 | PA |
N | 111NN0400X | Neurology | DC011427 | PA |
N | 111NN1001X | Nutrition | DC011427 | PA |
N | 111NP0017X | Pediatric Chiropractor | DC011427 | PA |
N | 111NR0200X | Radiology | DC011427 | PA |
N | 213ER0200X | Radiology | DC011427 | PA |
N | 111NR0400X | Rehabilitation Chiropractor | DC011427 | PA |
Y | 111NS0005X | Chiropractic Sports Physician | DC011427 | PA |
N | 111NT0100X | Thermography | DC011427 | PA |
N | 111NX0100X | Occupational Health | DC011427 | PA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC011427 | PA |
NPI | 1083273957 |
---|---|
Provider Name | Dr. Wayne D Lawrence |
First Address | Coraopolis, PA 15108-3842 |
Second Address | Coraopolis, PA 15108-3842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2019 |
Last Update Date | 23/12/2019 |