Individual
MR. TED L. LAURENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
12750 HIGHWAY 96, LANE 13, CROWLEY, CO 81034-0001
(719) 267-5071
(719) 267-5079
Mailing address
12750 HIGHWAY 96, LANE 13, CROWLEY, CO 81034-0001
(719) 267-5071
(719) 267-5079
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
543
CO
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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