Provider Demographics
NPI:1891950259
Name:LAWLER AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LAWLER AND ASSOCIATES, LLC
Other - Org Name:DEFINITIVE WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:DEGARMO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:864-631-2824
Mailing Address - Street 1:38 BOLAND CT
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5707
Mailing Address - Country:US
Mailing Address - Phone:864-631-2824
Mailing Address - Fax:
Practice Address - Street 1:38 BOLAND CT
Practice Address - Street 2:SUITE 106
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5707
Practice Address - Country:US
Practice Address - Phone:864-631-2824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAWLER AND ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDO340261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service