Provider Demographics
NPI:1033287404
Name:SVIHLA, LAWRENCE JAMES (DC)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:JAMES
Last Name:SVIHLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 WYTHE CREEK ROAD
Mailing Address - Street 2:SUITE E
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1931
Mailing Address - Country:US
Mailing Address - Phone:757-868-8822
Mailing Address - Fax:757-868-8844
Practice Address - Street 1:360 WYTHE CREEK RD
Practice Address - Street 2:SUITE E
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662-1975
Practice Address - Country:US
Practice Address - Phone:757-868-8822
Practice Address - Fax:757-868-8844
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV7462B630Medicare UPIN