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Individual

DR. LAWRENCE CHARLES PENVOSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1445 HARRISON AVENUE NW, CANTON, OH 44708
(330) 455-4531
(330) 455-0119
Mailing address
1445 HARRISON AVE NW STE 105, CANTON, OH 44708-2634
(330) 455-4531
(330) 455-0119

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34004573
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0821267
OH
Enumeration date
08/30/2006
Last updated
01/30/2013
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