Provider Demographics
NPI:1134285760
Name:LAWRENCE, DAVID (DC, ND)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:DC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SW WESTERN BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4067
Mailing Address - Country:US
Mailing Address - Phone:541-752-9918
Mailing Address - Fax:
Practice Address - Street 1:1600 SW WESTERN BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4067
Practice Address - Country:US
Practice Address - Phone:541-752-9918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273150111N00000X
OR1017175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered175F00000XOther Service ProvidersNaturopath