Individual
MR. JERRY ALAN LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REP
Contact information
Practice address
10061 FORRESTAL DR, HUNTINGTON BEACH, CA 92646-3717
(714) 403-1263
(714) 968-0747
Mailing address
10061 FORRESTAL DR, HUNTINGTON BEACH, CA 92646-3717
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
CA
Other
Enumeration date
03/30/2012
Last updated
07/21/2022
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