Healthcare Provider Details

I. General information

NPI: 1528001286
Provider Name (Legal Business Name): LAWRENCE D. HAMILTON JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 LINCOLN AVE STE 202
NORTH CHARLEROI PA
15022-2451
US

IV. Provider business mailing address

625 LINCOLN AVE STE 202
NORTH CHARLEROI PA
15022-2451
US

V. Phone/Fax

Practice location:
  • Phone: 724-929-4250
  • Fax:
Mailing address:
  • Phone: 724-929-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC003799L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: