Provider Demographics
NPI:1780339523
Name:LAWALL P & O OF FLORIDA, INC.
Entity type:Organization
Organization Name:LAWALL P & O OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-338-6611
Mailing Address - Street 1:3000 CABOT BLVD W
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1800
Mailing Address - Country:US
Mailing Address - Phone:215-338-6611
Mailing Address - Fax:215-338-9579
Practice Address - Street 1:1509 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2116
Practice Address - Country:US
Practice Address - Phone:321-300-7045
Practice Address - Fax:321-300-7179
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAWALL P & O OF FLORIDA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier