Individual
DR. GRANVILLE PAGE LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3252 WEST LAKE STREET #A, MINNEAPOLIS, MN 55416-5374
(612) 926-2878
(612) 920-4303
Mailing address
3252 WEST LAKE STREET #A, MINNEAPOLIS, MN 55416-5374
(612) 926-2878
(612) 920-4303
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1629
MN
152W00000X
Optometrist
MN1629
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114045732
GROUP NPI
MN
Enumeration date
10/10/2006
Last updated
09/02/2022
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