Provider Demographics
NPI:1730215872
Name:LAWLER, PETER J (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:LAWLER
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 1:780 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4114
Mailing Address - Country:US
Mailing Address - Phone:860-633-1928
Mailing Address - Fax:860-633-9054
Practice Address - Street 1:780 CHESTNUT HILL RD
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4114
Practice Address - Country:US
Practice Address - Phone:860-633-1928
Practice Address - Fax:860-633-9054
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT194111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT05-0000194CT03OtherANTHEM
CT060398OtherCONNECTICARE