Individual
AMANDA LARAE LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2340 NW 32ND ST, NEWCASTLE, OK 73065-6589
(405) 396-3322
(405) 392-3356
Mailing address
1200 CORPORATE DR, HOOVER, AL 35242-2941
(423) 777-6236
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT3780
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4429092R2001
BCBS OF OKLA
OK
Enumeration date
07/14/2005
Last updated
08/30/2023
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