Individual
FAITH T LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4288 WETZEL RD APT 212, LIVERPOOL, NY 13090-2242
(315) 935-0093
Mailing address
4288 WETZEL RD APT 212, LIVERPOOL, NY 13090-2242
(315) 935-0093
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
751437179
NY
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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