Individual
MR. LAWRENCE ALAN BARDACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR / L
Contact information
Practice address
750 FARROLL RD, UNIT E, GROVER BEACH, CA 93433-2654
(805) 481-7529
(805) 481-7529
Mailing address
750 FARROLL RD, UNIT E, GROVER BEACH, CA 93433-2654
(805) 481-7529
(805) 481-7529
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT4352
CA
Other
Enumeration date
07/31/2008
Last updated
07/31/2008
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