Provider Demographics
NPI:1194426585
Name:LAWRENCE, DEVAROE
Entity type:Individual
Prefix:
First Name:DEVAROE
Middle Name:
Last Name:LAWRENCE
Suffix:
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 1:4303 TAMALGA DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3521
Mailing Address - Country:US
Mailing Address - Phone:864-325-2718
Mailing Address - Fax:
Practice Address - Street 1:4303 TAMALGA DR
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3521
Practice Address - Country:US
Practice Address - Phone:864-325-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health