Provider Demographics
NPI:1093270266
Name:LAWRENSON, SCOTT G (ATC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:G
Last Name:LAWRENSON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 QUAIL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-1017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1971 UNIVERSITY BLVD
Practice Address - Street 2:LIBERTY UNIVERSITY SPORTS MED
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24515-2450
Practice Address - Country:US
Practice Address - Phone:434-592-6506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260009992083S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine