MEDICARE: LAWLOR CHIROPRACTIC LLC

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	2012024961	MO

General Provider Information

NPI Number	:	1609127745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWLOR CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	6028 WELDON SPRING PKWY
Second Line	:
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-9103
Country	:	US
Telephone Number	:	636-300-8250
Fax Number	:

Provider Business Practice Location Address
First Line	:	6028 WELDON SPRING PARKWAY
Second Line	:
City	:	WELDON SPRING
State	:	MO
Zip	:	63304
Country	:	US
Telephone Number	:	636-300-8250
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. JEFFREY THOMAS LAWLOR
Credential	:
Telephone Number	:	636-300-8250

Provider Enumeration Date	:	09/28/2012
Last Update Date	:	09/28/2012

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