Individual
LAWRENCE R WITHROW
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
T-LP
Contact information
Practice address
1919 N AMIDON AVE, STE. 130, WICHITA, KS 67203-2117
(316) 660-7675
(316) 832-1571
Mailing address
635 N MAIN ST, WICHITA, KS 67203-3602
(316) 660-7600
(316) 383-7925
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1254
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
392677
BLUE CROSS
KS
Enumeration date
06/10/2006
Last updated
07/08/2007
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