Provider Demographics
NPI:1386976272
Name:LAWRENCE, DANIEL EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDWARD
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 N RIVER RD NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-2543
Mailing Address - Country:US
Mailing Address - Phone:330-372-5550
Mailing Address - Fax:330-372-5551
Practice Address - Street 1:2048 N RIVER RD NE STE 3
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-2543
Practice Address - Country:US
Practice Address - Phone:330-372-5550
Practice Address - Fax:330-372-5551
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH4147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program