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Ms. Cynthia Lawrence

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NPI Number Detailed Information

Provider Information:

Name: Ms. Cynthia Lawrence
Gender: F
Provider License Number If Given: 2655

NPI Information:

NPI: 1568461093
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 8/8/2013

Provider Business Mailing Address:

Address: 2246 E PARKSIDE DR
Mohave Valley, AZ 86440
Phone Number: 9283302246
Fax Number: 9285542246

Provider Business Practice Location Address:

Address: 3357 E. PARKSIDE DRIVE
Mohave Valley, AZ 86440
Phone Number: 9283392246
Fax Number: 9285542246

Provider Taxonomy:

Primary: 363AM0700X
Secondary (if any):
State: AZ

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