| Healthsource Of Providence Llc | |
|
485 Providence Main St Nw Ste 100, Huntsville, AL 35806-4899 | |
| (256) 327-4900 | |
| Not Available |
| Full Name | Healthsource Of Providence Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 485 Providence Main St Nw Ste 100, Huntsville, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609123256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Joseph P Lawrence |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1275713661 PECOS PAC ID: 4486620846 Enrollment ID: I20080602000009 |
| Provider Name | Amy C Lawrence |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548543028 PECOS PAC ID: 6103085972 Enrollment ID: I20120314000402 |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Of Providence Llc 485 Providence Main Street, Suite 100, Huntsville, AL 35806-2673 Ph: (256) 221-0163 | Healthsource Of Providence Llc 485 Providence Main St Nw Ste 100, Huntsville, AL 35806-4899 Ph: (256) 327-4900 |
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