Wallen, Lawrence Clifford
Wallen, Lawrence Clifford is an sole proprietor health care provider with primary practice located at 21740 S Tamiami Trl #103, Estero FL 33928-2819. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Wallen, Lawrence Clifford can be contacted via phone (239) 676-9116.Contact Information
Primary practice address
21740 S Tamiami Trl #103
Estero FL 33928-2819
Phone: (239) 676-9116
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2301009662 | Michigan |
| Chiropractic Providers / Chiropractor | 111N00000X | CH10733 | Florida |
Profile Details
| NPI number | 1295050516 |
|---|---|
| LBN Legal business name | Wallen, Lawrence Clifford |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 30th, 2010 |
| Last updated | Oct 25th, 2016 - about 9 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 | 1295050516 | NPPES |
| Florida | MEDICAID | 008271600 |
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