Provider Demographics
NPI:1740932128
Name:LAWRENCE, DANNY R SR
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:R
Last Name:LAWRENCE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1707
Mailing Address - Country:US
Mailing Address - Phone:314-874-5739
Mailing Address - Fax:
Practice Address - Street 1:2335 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1707
Practice Address - Country:US
Practice Address - Phone:314-874-5739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services