Provider Demographics
NPI:1033246442
Name:LAWRENCE, RON K (PT)
Entity Type:Individual
Prefix:MR
First Name:RON
Middle Name:K
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:2105 E ENTERPRISE AVE
Mailing Address - Street 2:SUITE #113
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7862
Mailing Address - Country:US
Mailing Address - Phone:920-991-2561
Mailing Address - Fax:920-991-2563
Practice Address - Street 1:2105 E ENTERPRISE AVE
Practice Address - Street 2:SUITE #113
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7862
Practice Address - Country:US
Practice Address - Phone:920-991-2561
Practice Address - Fax:920-991-2563
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI10759-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist