Individual
ELIZABETH LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT, ATC
Contact information
Practice address
1121 SEMINOLE RD, NORTON SHORES, MI 49441-4345
(616) 403-6507
Mailing address
15993 PEACH RIDGE AVE, KENT CITY, MI 49330-9758
(616) 403-6507
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001064
MI
Other
Enumeration date
08/20/2017
Last updated
08/20/2017
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