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NPI 1104764729

NPI 1104764729 : ADAM LAWLOR : NORTH PROVIDENCE, RI

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General NPI Number Information
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    NPI Number           |    1104764729
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    Entity Type          |    Individual 
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    Provider Name        |    ADAM LAWLOR
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/24/2026
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    Last Update Date     |    03/24/2026
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Provider Practice Location Address
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    Address Line         |    1637 MINERAL SPRING AVE 
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    City                 |    NORTH PROVIDENCE
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    State                |    RI
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    Zip                  |    02904-4042
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    Country              |    US
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    Telephone            |    401-353-0800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    560 W COLONY RD 
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    City                 |    RIPON
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    State                |    CA
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    Zip                  |    95366-9452
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    Country              |    US
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    Telephone            |    209-305-5513
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    RI
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