Provider Demographics
NPI:1053456053
Name:LAWSON CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:LAWSON CHIROPRACTIC CORPORATION
Other - Org Name:THE HEALING TOUCH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRICK
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-447-3344
Mailing Address - Street 1:PO BOX 163118
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-9118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1919 21ST ST
Practice Address - Street 2:101
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-6827
Practice Address - Country:US
Practice Address - Phone:916-447-3344
Practice Address - Fax:916-447-3388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21399111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ06896ZOtherMEDICARE PTAN