Individual
TAMMY RUTH LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
8220 SAN DIEGO ST, ODESSA, TX 79765-8523
(432) 275-0511
Mailing address
8220 SAN DIEGO ST, ODESSA, TX 79765-8523
(432) 275-0511
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
SA00015
TX
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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