Healthcare Provider Details

I. General information

NPI: 1497969364
Provider Name (Legal Business Name): LAWRENCE PRECIPUO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 S MILITARY TRL SUITE D AND E
WEST PALM BEACH FL
33415-3963
US

IV. Provider business mailing address

750 S MILITARY TRL SUITE D AND E
WEST PALM BEACH FL
33415-3963
US

V. Phone/Fax

Practice location:
  • Phone: 561-687-2677
  • Fax: 561-687-2676
Mailing address:
  • Phone: 561-687-2677
  • Fax: 561-687-2676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH6216
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: