Provider Demographics
NPI:1972543528
Name:LAWRENCE, ROBERT CORY (LAC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CORY
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 W NC HIGHWAY 54 STE 300-126
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5577
Mailing Address - Country:US
Mailing Address - Phone:919-750-0027
Mailing Address - Fax:910-621-0003
Practice Address - Street 1:1415 W NC HIGHWAY 54 STE 300-126
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5577
Practice Address - Country:US
Practice Address - Phone:919-750-0027
Practice Address - Fax:910-621-0003
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC248171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist