Organization
LWN MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY W NICHOLS MD (OWNER)
(928) 537-7011
Entity
Organization
Contact information
Practice address
3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
(928) 368-2060
Mailing address
1600 S WHITE MOUNTAIN RD, SHOW LOW, AZ 85901-7106
(928) 537-7011
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
14326
AZ
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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