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Individual

JERRY M LAWRENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
21 PINE RD, KEYSVILLE, VA 23947-2018
(804) 787-3831
Mailing address
587 LAWRENCE LN # 6, KEYSVILLE, VA 23947-3611
(804) 787-3831

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
347C00000X
Private Vehicle

Other

Enumeration date
01/03/2020
Last updated
08/25/2020
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