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1649813254
LAWRENCE GENE BEAVERS
FAIRBORN, OH
NPI
1649813254
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2019-10-26
Last Update Date
2021-08-20
Business Address
Mr. LAWRENCE GENE BEAVERS
188 W HEBBLE AVE
FAIRBORN, OH 45324-4960
Phone number: 937-971-2350
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Mailing Address
Mr. LAWRENCE GENE BEAVERS
PO BOX 55
WALTON, KY 41094-0055
Phone number:
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