Individual
DR. LAWRENCE MOSURAK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6201 CHICAGO ROAD, WARREN, MI 48092
(586) 264-3621
(586) 264-3686
Mailing address
6201 CHICAGO ROAD, WARREN, MI 48092
(586) 264-3621
(586) 264-3686
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301010264
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2301010264
STATE LICENSE NUMBER
MI
Enumeration date
01/15/2015
Last updated
02/21/2019
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