MEDICARE: LAWRENCE REHABILITATION SPECIALISTS , INC

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	261QR0400X	Rehabilitation Clinic/Center	2305003976	VA

General Provider Information

NPI Number	:	1558444513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE REHABILITATION SPECIALISTS , INC

Provider Business Mailing Address
First Line	:	8191 STAPLES MILL ROAD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2751
Country	:	US
Telephone Number	:	804-523-2653
Fax Number	:	804-767-4415

Provider Business Practice Location Address
First Line	:	8191 STAPLES MILL ROAD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2751
Country	:	US
Telephone Number	:	804-523-2653
Fax Number	:	804-767-4415

Authorized Official
Title or Position	:	OWNER/PRESIDENT/THERAPIST
Name	:	DAVID ALLEN LAWRENCE
Credential	:	PT, MSPT
Telephone Number	:	804-523-2653

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	03/17/2020

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