Healthcare Provider Details

I. General information

NPI: 1649382045
Provider Name (Legal Business Name): HARRY J . LAWALL & SON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 PENN AVE
WYOMISSING PA
19610-2033
US

IV. Provider business mailing address

8028 FRANKFORD AVE
PHILADELPHIA PA
19136-2616
US

V. Phone/Fax

Practice location:
  • Phone: 610-372-3511
  • Fax: 215-657-3742
Mailing address:
  • Phone: 215-338-6611
  • Fax: 215-338-9579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. HARRY J LAWALL
Title or Position: VICE PRESIDENT
Credential: CPO
Phone: 215-338-6611