| Doctor Name: | MR. LARRY LAWSON |
| NPI Number: | 1205065000 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | CT1402 |
| Business Practice Address: | 51 Shunpike Rd Suite 29 Cromwell, CT - 064162497 |
| Business Phone Number: | 8606354600 |
| Business Fax Number: | 8606354650 |
| Mailing Address: | Po Box 4153, HARTFORD |
| State: | CT |
| Postal Code: | 061474153 |
| Phone Number: | 8606354600 |
| Fax Number: | 8606354650 |
| NPI Enumeration Date: | 07/14/2009 |
| NPI Last Update Date: | 07/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | CT1402 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |