Individual
DR. LAWRENCE JOHN GRANLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5675 STONE RD, SUITE 220, CENTREVILLE, VA 20120-1667
(703) 815-0700
(703) 815-0701
Mailing address
5675 STONE RD, SUITE 220, CENTREVILLE, VA 20120-1667
(703) 815-0700
(703) 815-0701
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000909
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093770
PROVIDER NUMBER-ANTHEM
VA
Enumeration date
10/20/2005
Last updated
07/08/2007
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