Provider Demographics
NPI:1578218699
Name:LAWRENCE DESIGNS
Entity Type:Organization
Organization Name:LAWRENCE DESIGNS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANGER
Authorized Official - Prefix:
Authorized Official - First Name:TA
Authorized Official - Middle Name:TANISHA
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-289-0800
Mailing Address - Street 1:1002 INGERSOLL DR STE 5
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-6040
Mailing Address - Country:US
Mailing Address - Phone:706-289-0800
Mailing Address - Fax:334-326-4988
Practice Address - Street 1:1002 INGERSOLL DR STE 5
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-6040
Practice Address - Country:US
Practice Address - Phone:706-289-0800
Practice Address - Fax:334-326-4988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAUTIFUL CROWNS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-17
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier