MEDICARE: DR. WAYNE D LAWRENCE DC

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
1	111N00000X	Chiropractor	DC011427	PA
2	111NI0013X	Independent Medical Examiner Chiropractor	DC011427	PA
3	111NI0900X	Internist Chiropractor	DC011427	PA
4	111NN0400X	Neurology Chiropractor	DC011427	PA
5	111NN1001X	Nutrition Chiropractor	DC011427	PA
6	111NP0017X	Pediatric Chiropractor	DC011427	PA
7	111NR0200X	Radiology Chiropractor	DC011427	PA
8	111NR0400X	Rehabilitation Chiropractor	DC011427	PA
9	111NT0100X	Thermography Chiropractor	DC011427	PA
10	111NX0100X	Occupational Health Chiropractor	DC011427	PA
11	111NX0800X	Orthopedic Chiropractor	DC011427	PA
12	111NS0005X	Sports Physician Chiropractor	DC011427	PA

General Provider Information

NPI Number	:	1083273957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE D LAWRENCE DC

Provider Business Mailing Address
First Line	:	1635 BRODHEAD RD
Second Line	:
City	:	CORAOPOLIS
State	:	PA
Zip	:	15108-3842
Country	:	US
Telephone Number	:	724-910-3235
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 BRODHEAD RD
Second Line	:
City	:	CORAOPOLIS
State	:	PA
Zip	:	15108-3842
Country	:	US
Telephone Number	:	724-910-3235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2019
Last Update Date	:	12/23/2019

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