Provider Demographics
NPI:1053643056
Name:WILLIAMS, LAWRENCE C (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 N MAIN ST
Mailing Address - Street 2:SUITE. 1060
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-6634
Mailing Address - Country:US
Mailing Address - Phone:661-575-7463
Mailing Address - Fax:661-251-0315
Practice Address - Street 1:18830 SOLEDAD CANYON RD
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-3772
Practice Address - Country:US
Practice Address - Phone:661-575-7463
Practice Address - Fax:661-251-0315
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 30802111NN0400X, 111NR0400X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0100XChiropractic ProvidersChiropractorOccupational Health