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Individual

MR. SHANE MICHAEL LAWLER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
104 JUNGERMAN RD, SUITE F, ST PETERS, MO 63376
(636) 926-2641
(636) 926-3385
Mailing address
3868 MEXICO RD, ST CHARLES, MO 63303
(636) 926-0408
(636) 926-0295

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2000157231
MO

Other

Enumeration date
05/23/2006
Last updated
07/08/2007
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