Individual
SCOTT CHARLES LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
245 CHERRY ST SE, SUITE 202, GRAND RAPIDS, MI 49503-4607
(616) 459-3551
(616) 459-1060
Mailing address
245 CHERRY ST SE, SUITE 202, GRAND RAPIDS, MI 49503-4607
(616) 459-3551
(616) 459-1060
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
SL004357
MI
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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