Provider Demographics
NPI:1073872479
Name:LAWRENCE FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:LAWRENCE FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:JASZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-393-1600
Mailing Address - Street 1:2304 BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2304 BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08648-4411
Practice Address - Country:US
Practice Address - Phone:609-393-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00673100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty