| Doctor Name: | MR. SHANE MICHAEL LAWLER |
| NPI Number: | 1528013398 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 2000157231 |
| Business Practice Address: | 104 Jungerman Rd Suite F St Peters, MO - 63376 |
| Business Phone Number: | 6369262641 |
| Business Fax Number: | 6369263385 |
| Mailing Address: | 3868 Mexico Rd, ST CHARLES |
| State: | MO |
| Postal Code: | 63303 |
| Phone Number: | 6369260408 |
| Fax Number: | 6369260295 |
| NPI Enumeration Date: | 05/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 2000157231 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |