Provider Demographics
NPI:1891746509
Name:LAWRENCE, ROBYN LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:LYNN
Last Name:LAWRENCE
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 1:111 CHURCH ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2441
Mailing Address - Country:US
Mailing Address - Phone:314-524-2580
Mailing Address - Fax:314-524-2596
Practice Address - Street 1:111 CHURCH ST
Practice Address - Street 2:SUITE 111
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2441
Practice Address - Country:US
Practice Address - Phone:314-524-2580
Practice Address - Fax:314-524-2596
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006555111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO156150OtherBCBS NO.
MOU80314Medicare UPIN
MO156150OtherBCBS NO.