Healthcare Provider Details

I. General information

NPI: 1447592936
Provider Name (Legal Business Name): JOSEPH L. LAWSON ABC/BOC ORTHOTIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 FIRST COLONIAL RD
VIRGINIA BEACH VA
23454-2402
US

IV. Provider business mailing address

1135 FIRST COLONIAL RD
VIRGINIA BEACH VA
23454-2402
US

V. Phone/Fax

Practice location:
  • Phone: 757-631-6311
  • Fax: 757-631-2659
Mailing address:
  • Phone: 757-631-6311
  • Fax: 757-631-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: