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Individual

LAWRENCE R CHEAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHYSICAL THERAPIST

Contact information

Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
(541) 266-4526
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
(541) 266-4526

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3352
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1407812365
GROUP NPI
OR
01
161133
NBMC GROUP MEDICAID
OR
05
271046
OR
01
930635514
GROUP TAX ID
OR
01
R0000WFBTV
GROUP MEDICARE
OR
Enumeration date
09/29/2006
Last updated
05/20/2013
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