Individual
LAWRENCE R CHEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
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
Update your record
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