Individual
VYVIAN CHARLENE LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DVM
Contact information
Practice address
5939 W LINCOLN HWY, CROWN POINT, IN 46307-9604
(219) 515-6904
Mailing address
707 81ST ST, DOWNERS GROVE, IL 60516-4333
(630) 664-8696
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
090004455
IL
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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