DR. LAWRENCE CLIFFORD WALLEN III (NPI# 1295050516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295050516 |
| Entity Type | Individual |
| Full Name | DR. LAWRENCE CLIFFORD WALLEN III |
| Credential | D.C. |
| Practice Address |
21740 S Tamiami Trl #103 Estero FL 33928-2819 |
| Practice Telephone | 2396769116 |
| Mailing Telephone | 2396769116 |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2016-10-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH10733 | FL | Chiropractic Providers |
| N | 111N00000X | Chiropractor | 2301009662 | MI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 008271600 | 05 |
| Street Address |
21740 S TAMIAMI TRL #103 |
| City | ESTERO |
| State | FL |
| Zip Code | 33928-2819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578055588 | Jeremiah S Mossman | Nurse Anesthetist, Certified Registered | 21586 Belvedere Ln, Estero, FL 33928 | 2018-06-05 |
| 1376030361 | Trish Daino Lisw LLC | Social Worker | 9180 Estero Park Commons, Ste 2, Suite 2, Estero, FL 33928 | 2018-04-16 |
| 1861994204 | Kin Med, Pa | General Practice | 19910 S Tamiami Trail Ste C, Estero, FL 33928 | 2018-03-01 |
| 1073031225 | Dieu Huyen Thi Le | Pharmacist | 20311 Grande Oak Blvd, Estero, FL 33928 | 2017-09-07 |
| 1295284008 | National Vision, Inc. | Technician/Technologist | 22907 Lyden Dr, Estero, FL 33928 | 2016-09-22 |
| 1275982654 | Eileen Cherbini | Counselor | 13616 Canola Ct, Estero, FL 33928 | 2016-06-07 |
| 1952759342 | Alexander Conrad | Counselor | 8010 Sardinia Way Unit #221, Estero, FL 33928 | 2016-05-26 |
| 1154700466 | Estero Eyecare | Clinic/Center | 21753 Brixham Run Loop, Estero, FL 33928 | 2015-05-20 |
| 1982082335 | Gulfshore Pediatric Dentistry, P.a. | Dentist | 9921 Corkscrew Rd, Estero, FL 33928 | 2015-05-18 |
| 1942697149 | Conor William Byrt | Emergency Medicine | 21731 Sound Way, 102, Estero, FL 33928 | 2015-04-25 |
| Find all providers in zip 33928 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679826705 | Estero Family Chiropractic LLC | Chiropractor | 21740 S Tamiami Trl Ste 103, Estero, FL 33928-2819 | 2012-10-26 |
| 1285892760 | Boyrer Chiropractic P A | Chiropractor | 19910 S Tamiami Trl Ste D, Estero, FL 33928-4140 | 2008-05-30 |
| 1649469727 | Mark Adam Compton | Chiropractor | 21835 Rainbow Lake Ct, Estero, FL 33928-6297 | 2007-10-15 |
| 1265508428 | Michael Aaron Sills | Chiropractor | 20048 Heatherstone Way Unit 4, Estero, FL 33928-3080 | 2006-11-28 |
| 1194775668 | Michelle Giroux | Chiropractor | 9250 Corkscrew Rd Ste 4, Estero, FL 33928-3216 | 2006-05-12 |
| 1427052935 | Michael G Boyrer | Chiropractor | 19910 S Tamiami Trl, Ste D, Estero, FL 33928-4140 | 2005-06-13 |
| 1992206155 | Kinmed, P.a. | Chiropractor | 19910 S Tamiami Trl Ste C, Estero, FL 33928-4140 | 2018-02-23 |
| 1093947970 | David C Adamson | Chiropractor | 19910 S Tamiami Trl Ste C, Estero, FL 33928-4140 | 2009-08-11 |
| 1386894582 | Compton Chiropractic Clinic Inc | Chiropractor | 21835 Rainbow Lake Ct, Estero, FL 33928-6297 | 2008-09-24 |
| 1538350103 | Russell E. Turner Dc Pllc | Chiropractor | 10201 Arcos Ave, Suite 205, Estero, FL 33928-9459 | 2007-08-07 |
| Find all providers in ESTERO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.