# BROKEN BOW CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528151651
- **Authorized official:** MRS. SHAWN S LAWRENCE MD (PHYSICIAN OWNER)
- **Authorized official phone:** (308) 872-6456

## Contact information

- **Practice address:** 805 SOUTH F STREET, BROKEN BOW, NE 68822-0647
- **Practice address phone:** (308) 872-6456
- **Practice address fax:** (308) 872-6040
- **Mailing address:** 805 SOUTH F STREET, PO BOX 647, BROKEN BOW, NE 68822-0647
- **Mailing address phone:** (308) 872-6456
- **Mailing address fax:** (308) 872-6040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 09/19/2011