Individual
DONALD R LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1412 FAIRMOUNT AVE., PHILADELPHIA, PA 19130
(215) 599-4851
(215) 232-4093
Mailing address
1412 FAIRMOUNT AVE, PHILADELPHIA, PA 19130-2908
(215) 599-4851
(215) 232-4093
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA001619L
PA
Other
Enumeration date
05/18/2007
Last updated
08/03/2011
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