Provider Demographics
NPI:1306060645
Name:BOYD, LAWRENCE P III (DC)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:P
Last Name:BOYD
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:64 E WINE ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2763
Mailing Address - Country:US
Mailing Address - Phone:724-929-6077
Mailing Address - Fax:724-929-9410
Practice Address - Street 1:1100 FAYETTE AVE
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-2304
Practice Address - Country:US
Practice Address - Phone:724-929-6077
Practice Address - Fax:724-929-9410
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009766111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAWV5228AMedicare PIN