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General NPI Number Information
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NPI Number | 1093270266
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Entity Type | Individual
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Provider Name | SCOTT G LAWRENSON ATC
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Gender | Male
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 1971 UNIVERSITY BLVD LIBERTY UNIVERSITY SPORTS MED
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City | LYNCHBURG
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State | VA
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Zip | 24515-2450
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Country | US
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Telephone | 434-592-6506
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Fax |
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Provider Business Mailing Address
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Address Line | 301 QUAIL RIDGE DR
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City | FOREST
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State | VA
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Zip | 24551-1017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083S0010X
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Taxonomy Name | Sports Medicine (Preventive Medicine) Physician
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License Number | 0126000999
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License Number State | VA
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