Individual
MR. LAWRENCE AMOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
103 FREE BRIDGE LN, CHARLOTTESVILLE, VA 22911-8446
(802) 338-0644
Mailing address
937 TILMAN RD, CHARLOTTESVILLE, VA 22901-6338
(802) 338-0644
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
MA0025517
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019008058
DEPT. OF HEALTH PROFESSIONS
VA
01
—
MA 25517
STATE LICENSE NUMBER
FL
Enumeration date
11/17/2006
Last updated
06/30/2009
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