Individual
LAWRENCE BLAIR NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1910 S STAPLEY DR, STE 221, MESA, AZ 85204-6680
(602) 803-5032
(480) 386-5040
Mailing address
5235 E SOUTHERN AVE, STE D106-438, MESA, AZ 85206-3626
(602) 803-5032
(480) 452-0921
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4564
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137696
—
AZ
Enumeration date
10/20/2006
Last updated
06/05/2017
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