Healthcare Provider Details

I. General information

NPI: 1669804613
Provider Name (Legal Business Name): IPM INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 BAYSHORE GARDENS PKWY
BRADENTON FL
34207-4857
US

IV. Provider business mailing address

1215 BAYSHORE GARDENS PKWY
BRADENTON FL
34207-4857
US

V. Phone/Fax

Practice location:
  • Phone: 941-243-3887
  • Fax: 941-243-3887
Mailing address:
  • Phone: 941-251-5930
  • Fax: 941-251-5931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME59641
License Number StateFL

VIII. Authorized Official

Name: DR. HAROLD J LAWLER III
Title or Position: OWNER
Credential: MD
Phone: 941-251-5930