Individual
TIMOTHY W LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
803 W POPLAR ST, TAYLORVILLE, IL 62568-1815
(217) 827-2925
Mailing address
803 W POPLAR ST, TAYLORVILLE, IL 62568-1815
(217) 827-2925
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180-001855
IL
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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