NPI 1164813499

Ryan Martin Lawrence, PAC

Practitioner Physician Assistant Oak Creek, WI

Practice location

Address: 200 E Ryan Rd, Oak Creek, WI 53154-4563
Phone: (414) 570-3590
Fax: (414) 570-3599
Mailing address: PO Box 735044, Chicago, IL 60673-5044

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 3491-23 (WI)

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Registry record

NPI: 1164813499
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Feb 2015
Record last updated: 2 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.