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General NPI Number Information
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NPI Number | 1790833168
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Entity Type | Organization
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Legal Business Name | LAWRENCE E. BRIDGES DC LTD
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2 EMERALD TER
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City | SWANSEA
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State | IL
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Zip | 62226-2321
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Country | US
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Telephone | 618-234-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2 EMERALD TER
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City | SWANSEA
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State | IL
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Zip | 62226-2321
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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 | PRESIDENT
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Name | DR. LAWRENCE BRIDGES
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Credential | DC
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Telephone | 618-234-8000
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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 |
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License Number State |
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