Provider Demographics
NPI:1013343466
Name:LAWRENCE .E. ANDERSON .D.C. P.C.
Entity Type:Organization
Organization Name:LAWRENCE .E. ANDERSON .D.C. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAWRENCE .E.E ANDERSON .D.C
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC PC
Authorized Official - Phone:205-647-0044
Mailing Address - Street 1:206 MAIN ST N
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180-1347
Mailing Address - Country:US
Mailing Address - Phone:205-647-0044
Mailing Address - Fax:205-647-0044
Practice Address - Street 1:206 MAIN ST N
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180-1347
Practice Address - Country:US
Practice Address - Phone:205-647-0044
Practice Address - Fax:205-647-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL70443OtherBCBS
AL000070443OtherMEDICARE
ALT68317OtherUPIN
AL350040704OtherRR