Most Relevant Information
Provider Data
| NPI Number: | 1003830225 |
| Provider Name: | SCOTT CHARLES LAWRENCE PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | SL004357 |
Most Important Dates
| Enumeration Date: | 07/27/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
245 CHERRY ST SE
SUITE 202
GRAND RAPIDS
MI
495034607
Practice Location Phone/Fax
| Phone: | 6164593551 |
| Fax: | 6164591060 |
Provider Mailing Location
245 CHERRY ST SE
SUITE 202
GRAND RAPIDS
MI
495034607
Provider Mailing Phone/Fax
| Phone: | 6164593551 |
| Fax: | 6164591060 |