Individual
GREGORY L LAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3122 BRETTWOOD CIR, DECATUR, IL 62526-2425
(217) 876-4600
Mailing address
3122 BRETTWOOD CIR, DECATUR, IL 62526-2425
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.003820
IL
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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