Provider Demographics
NPI:1285158626
Name:LAWRENCE, LORENE (LMMT, RYT, CAP)
Entity type:Individual
Prefix:
First Name:LORENE
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LMMT, RYT, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 BOULDER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PAGOSA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81147-9889
Mailing Address - Country:US
Mailing Address - Phone:970-422-7161
Mailing Address - Fax:
Practice Address - Street 1:390 BOULDER DR STE 100
Practice Address - Street 2:
Practice Address - City:PAGOSA SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81147-9889
Practice Address - Country:US
Practice Address - Phone:970-422-7161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist