Provider Demographics
NPI:1710259155
Name:PETER J. LAWLER, D.C.,P.C.
Entity Type:Organization
Organization Name:PETER J. LAWLER, D.C.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-633-1928
Mailing Address - Street 1:780 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4114
Mailing Address - Country:US
Mailing Address - Phone:860-622-1928
Mailing Address - Fax:860-633-9054
Practice Address - Street 1:780 CHESTNUT HILL RD
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4114
Practice Address - Country:US
Practice Address - Phone:860-622-1928
Practice Address - Fax:860-633-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT194261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service