Individual
LAWRENCE ELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1940 MARAVILLA AVE, FORT MYERS, FL 33901-7135
(239) 334-0222
(239) 334-0244
Mailing address
1940 MARAVILLA AVE, FORT MYERS, FL 33901-7135
(239) 334-0222
(239) 334-0244
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/07/2016
Last updated
01/07/2016
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