Individual
DR. EDWARD JOSEPH LAUTERBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
202 TURKEYSAG TRL, SUITE 5, PALMYRA, VA 22963-2656
(434) 591-0900
Mailing address
202 TURKEYSAG TRL, SUITE 5, PALMYRA, VA 22963-2656
(434) 591-0900
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001713
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
462512
ANTHEM
VA
Enumeration date
02/06/2006
Last updated
07/08/2007
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