Healthcare Provider Details

I. General information

NPI: 1629295514
Provider Name (Legal Business Name): LEA LAWSON CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4602 CHARLESTOWN RD
NEW ALBANY IN
47150-9557
US

IV. Provider business mailing address

4602 CHARLESTOWN RD
NEW ALBANY IN
47150-9557
US

V. Phone/Fax

Practice location:
  • Phone: 812-944-4455
  • Fax: 812-944-4457
Mailing address:
  • Phone: 812-944-4455
  • Fax: 812-944-4457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. LEA R KOONS
Title or Position: PRESIDENT
Credential: D.C.
Phone: 812-944-4457