Provider Demographics
NPI:1073597662
Name:LAWSON, KENTON ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:KENTON
Middle Name:ANDREW
Last Name:LAWSON
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 1:80 PEACHTREE RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3156
Mailing Address - Country:US
Mailing Address - Phone:828-274-8880
Mailing Address - Fax:828-274-8881
Practice Address - Street 1:80 PEACHTREE RD
Practice Address - Street 2:STE. 100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3156
Practice Address - Country:US
Practice Address - Phone:828-274-8880
Practice Address - Fax:828-274-8881
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC624026OtherACN PROVIDER #
NC89085G5Medicaid
NC624026OtherACN PROVIDER #
NCU90003Medicare UPIN