Individual
LAWRENCE BREWERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10352 N 600 E, DEMOTTE, IN 46310-8959
(219) 345-5811
Mailing address
8670 LANTERN DR, SAINT JOHN, IN 46373-9671
(847) 673-0718
(847) 673-0875
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
IL
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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