Provider Demographics
NPI:1598835951
Name:LAWSON, LENORE LOUISE (DC)
Entity Type:Individual
Prefix:
First Name:LENORE
Middle Name:LOUISE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 EDISON ST
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723-2516
Mailing Address - Country:US
Mailing Address - Phone:970-842-5500
Mailing Address - Fax:970-842-3772
Practice Address - Street 1:220 EDISON ST
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723-2516
Practice Address - Country:US
Practice Address - Phone:970-842-5500
Practice Address - Fax:970-842-3772
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COL07-36517OtherSTATE ID
COC28913Medicare ID - Type Unspecified
COU48483Medicare UPIN