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NPI Code Detail

MEDICARE: DR. LAWRENCE S NICHOLS III D.C.

MEDICARE: DR. LAWRENCE S NICHOLS III D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor1297AR

General Provider Information

NPI Number : 1033110804
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE S NICHOLS III D.C.
Provider Business Mailing Address
First Line : 2696 HWY 77 S
Second Line :
City : MARION
State : AR
Zip : 72364-2373
Country : US
Telephone Number : 870-739-2500
Fax Number : 870-739-4979
Provider Business Practice Location Address
First Line : 2696 HWY 77 S
Second Line :
City : MARION
State : AR
Zip : 72364-2373
Country : US
Telephone Number : 870-739-2500
Fax Number : 870-739-4979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 05/06/2010

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