MR. Randall Wayne Lawrence, PT

NPI #1568414803 in Benton, Illinois

Provider Information

NPI Number: 1568414803
Entity Type: Individual
Name: MR. Randall Wayne Lawrence, PT
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: May 16, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1104 W MAIN ST
City: Benton
State: Illinois
ZIP Code: 62812-1565
Phone: (618) 439-3399

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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Organizations

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