Provider Demographics
NPI:1265138077
Name:LAWRENCE, RYAN DENNIS (DC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:DENNIS
Last Name:LAWRENCE
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 1:8115 ISABELLA LN STE 8
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-9110
Mailing Address - Country:US
Mailing Address - Phone:615-721-5141
Mailing Address - Fax:615-235-0079
Practice Address - Street 1:8115 ISABELLA LN STE 8
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-9110
Practice Address - Country:US
Practice Address - Phone:615-721-5141
Practice Address - Fax:615-235-0079
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty