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General NPI Number Information
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NPI Number | 1669422564
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Entity Type | Individual
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Provider Name | CHAD EVAN LAURENCE DC
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 7503 A LANCASTER PIKE
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City | HOCKESSIN
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State | DE
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Zip | 19707-9593
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Country | US
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Telephone | 302-234-1115
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Fax | 302-234-6661
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Provider Business Mailing Address
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Address Line | 7503 LANCASTER PIKE STE A
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City | HOCKESSIN
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State | DE
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Zip | 19707-9593
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Country | US
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Telephone | 302-234-1115
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Fax | 302-234-6661
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | F10000514
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License Number State | DE
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