Provider Demographics
NPI:1972839652
Name:PRESTON, LAWRENCE EUGENE (DC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:EUGENE
Last Name:PRESTON
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 1:420 SE 17TH ST # 314A
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4433
Mailing Address - Country:US
Mailing Address - Phone:352-351-5343
Mailing Address - Fax:
Practice Address - Street 1:420 SE 17TH ST # 314A
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4433
Practice Address - Country:US
Practice Address - Phone:352-351-5343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH1517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor