Individual
LAWRENCE DIAZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
629 NUCKOLLS RD, BOLIVAR, TN 38008-1599
(731) 658-3388
(731) 658-4079
Mailing address
PO BOX 720, BOLIVAR, TN 38008-0720
(731) 658-3388
(731) 658-4079
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1322
TN
Other
Enumeration date
02/24/2006
Last updated
07/08/2007
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