Provider Demographics
NPI:1720064363
Name:SAVAGE, LAWRENCE FRANCIS (DC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:FRANCIS
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:4604 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2619
Mailing Address - Country:US
Mailing Address - Phone:520-321-0331
Mailing Address - Fax:520-321-0334
Practice Address - Street 1:4604 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2619
Practice Address - Country:US
Practice Address - Phone:520-321-0331
Practice Address - Fax:520-321-0334
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU90802Medicare UPIN
AZ70728Medicare ID - Type Unspecified