Provider Demographics
NPI:1588718415
Name:SCHWANKE, LAWRENCE EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:EDWARD
Last Name:SCHWANKE
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:PO BOX 1385
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34421-1385
Mailing Address - Country:US
Mailing Address - Phone:352-369-9868
Mailing Address - Fax:352-369-0168
Practice Address - Street 1:3910 S PINE AVE STE C
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-4931
Practice Address - Country:US
Practice Address - Phone:352-369-9868
Practice Address - Fax:352-369-0168
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55927OtherBLUE CROSS
FL381264200Medicaid
55927Medicare PIN
FL381264200Medicaid