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General NPI Number Information
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NPI Number | 1902027824
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Entity Type | Individual
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Provider Name | LAWRENCE RODDICK D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 94 BRIGGS ST STE 150
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City | SAN ANTONIO
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State | TX
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Zip | 78224-1206
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Country | US
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Telephone | 210-921-0265
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Fax | 210-922-9679
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Provider Business Mailing Address
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Address Line | 9503 KEITH ANTHONY 94 BRIGGS STE 150
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City | HELOTES
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State | TX
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Zip | 78023-4160
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Country | US
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Telephone | 210-921-0265
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Fax | 210-922-9679
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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 | DC 6109
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License Number State | TX
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