Provider Demographics
NPI:1912021122
Name:ADAMS, LAURENCE J (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:J
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ANDRIEUX ST
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6906
Mailing Address - Country:US
Mailing Address - Phone:707-996-4535
Mailing Address - Fax:707-996-8510
Practice Address - Street 1:101 ANDRIEUX ST
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6906
Practice Address - Country:US
Practice Address - Phone:707-996-4535
Practice Address - Fax:707-996-8510
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24690111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPINOtherDC0246900
CAZZZ56492ZOtherBLUE SHIELD
CAPINOtherDC0246900
CAU69580Medicare UPIN