Provider Demographics
NPI:1457125395
Name:LAWRENCE, JAMES II
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:LAWRENCE
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 INSURANCE CT
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-0357
Mailing Address - Country:US
Mailing Address - Phone:304-820-2929
Mailing Address - Fax:
Practice Address - Street 1:47 INSURANCE CT
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-0357
Practice Address - Country:US
Practice Address - Phone:304-820-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker