Provider Demographics
NPI:1174664015
Name:NINESLING, LAWRENCE PHILIP (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:PHILIP
Last Name:NINESLING
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 1:4150 SALEM DR
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-3331
Mailing Address - Country:US
Mailing Address - Phone:610-965-0700
Mailing Address - Fax:
Practice Address - Street 1:4051 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-1013
Practice Address - Country:US
Practice Address - Phone:610-965-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007228L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02965600OtherBLUE CROSS ID
PA19667590002Medicaid
PA1356859OtherBLUE SHIELD ID
PA1356859OtherBLUE SHIELD ID
PA02965600OtherBLUE CROSS ID