Healthcare Provider Details

I. General information

NPI: 1689862211
Provider Name (Legal Business Name): D S LAWRENCE DC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3534 E 51ST ST
TULSA OK
74135-3518
US

IV. Provider business mailing address

8711 S HARVARD
TULSA OK
74137-1734
US

V. Phone/Fax

Practice location:
  • Phone: 918-504-4182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3840
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3839
License Number StateOK

VIII. Authorized Official

Name: DR. SCOTTIE RAE LAWRENCE
Title or Position: OWNER
Credential: DC
Phone: 918-398-8513