Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD111733 | MO |
NPI | 1265599591 |
---|---|
Provider Name | Lawrence Paul Landwehr |
First Address | Warrensburg, MO 64093-2958 |
Second Address | Warrensburg, MO 64093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 29/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G06202 | (02) | MO |