MEDICARE: DR. DANIEL EDWARD LAWRENCE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	111N00000X	Chiropractor	4147	OH

General Provider Information

NPI Number	:	1386976272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL EDWARD LAWRENCE D.C.

Provider Business Mailing Address
First Line	:	2048 N RIVER RD NE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-2543
Country	:	US
Telephone Number	:	330-372-5550
Fax Number	:	330-372-5551

Provider Business Practice Location Address
First Line	:	2048 N RIVER RD NE STE 3
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-2543
Country	:	US
Telephone Number	:	330-372-5550
Fax Number	:	330-372-5551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2010
Last Update Date	:	09/12/2017

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