Individual
VALERIE ELIZABETH LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2512 HURST DR, STE 130, MATTOON, IL 61938
(217) 258-5900
(217) 258-3686
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036138867
IL
390200000X
Student in an Organized Health Care Education/Training Program
63210
NY
Other
Enumeration date
04/25/2012
Last updated
08/06/2016
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