Individual
JIMMY LYNN LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
675 WASHINGTON ST SW, BLACKSBURG, VA 24060-9523
(540) 231-5690
(540) 231-7335
Mailing address
675 WASHINGTON ST SW, BLACKSBURG, VA 24060-9523
(540) 231-5690
(540) 231-7335
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
126000313
VA
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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