Burdette, Lawrence Wilson
Burdette, Lawrence Wilson is an sole proprietor health care provider with primary practice located at 618 Fairmont Ave , Fairmont WV 26554-5104. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Burdette, Lawrence Wilson can be contacted via phone (304) 365-5555.Contact Information
Primary practice address
618 Fairmont Ave
Fairmont WV 26554-5104
Phone: (304) 365-5555
Fax: (304) 363-4008
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 800 | West Virginia |
Profile Details
| NPI number | 1811047814 |
|---|---|
| LBN Legal business name | Burdette, Lawrence Wilson |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 11th, 2007 |
| Last updated | Mar 22nd, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811047814 | NPPES |
| West Virginia | MEDICAID | 3810001785 |
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