Provider Demographics
NPI:1508022054
Name:LAWRENCE, THOMAS H IV (OTD, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:H
Last Name:LAWRENCE
Suffix:IV
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 CHAMBLISS RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-6381
Mailing Address - Country:US
Mailing Address - Phone:901-348-2273
Mailing Address - Fax:
Practice Address - Street 1:1076 CHAMBLISS RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6381
Practice Address - Country:US
Practice Address - Phone:901-348-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
TNOT0000003111313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist