Provider Demographics
NPI:1376842641
Name:LAWRENCE, FLO DELANE (LAC)
Entity Type:Individual
Prefix:
First Name:FLO
Middle Name:DELANE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:28005 SMYTH DR # 107
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4023
Mailing Address - Country:US
Mailing Address - Phone:661-255-3388
Mailing Address - Fax:661-297-7343
Practice Address - Street 1:28005 SMYTH DR # 107
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4023
Practice Address - Country:US
Practice Address - Phone:661-255-3388
Practice Address - Fax:661-297-7343
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA3377171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist