MEDICARE: AARON B LAWRENCE

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	152W00000X	Optometrist	4948	OH

General Provider Information

NPI Number	:	1366695314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AARON B LAWRENCE

Provider Business Mailing Address
First Line	:	33 E MAIN ST
Second Line	:
City	:	NEW CONCORD
State	:	OH
Zip	:	43762-1214
Country	:	US
Telephone Number	:	740-826-1111
Fax Number	:	740-826-2222

Provider Business Practice Location Address
First Line	:	33 E MAIN ST
Second Line	:
City	:	NEW CONCORD
State	:	OH
Zip	:	43762-1214
Country	:	US
Telephone Number	:	740-826-1111
Fax Number	:	740-826-2222

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AARON B LAWRENCE
Credential	:	OD
Telephone Number	:	740-826-1111

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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