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MR. TED L. LAURENCE PA

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1346315769

Individual Registrant:
MR. TED L. LAURENCE PA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
12750 HIGHWAY 96 LANE 13 CROWLEY, CO 81034-0001 US
Tel: 719-267-5071  Fax: 719-267-5079

Contact information for business:
12750 HIGHWAY 96 LANE 13 CROWLEY, CO 81034-0001 US
Tel: 719-267-5071  Fax: 719-267-5079

Registration Information:
NPI: 1346315769
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
CO543

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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