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General NPI Number Information
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NPI Number | 1760705404
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Entity Type | Organization
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Legal Business Name | ADBO LLC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 989 S MAIN ST, STE A#431
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4602
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Country | US
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Telephone | 480-422-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1784 E VISTA DE MONTANA
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City | COTTONWOOD
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State | AZ
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Zip | 86326-6957
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Country | US
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Telephone | 480-422-7000
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Fax |
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | DR. BEVERLY A LAWRENCE
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Credential | PH.D.,C.A.HT.,L.AC.
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Telephone | 480-422-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0711
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License Number State | AZ
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