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NPI Code Detail

MEDICARE: DR. KENYA LATRICE LAWSON DPT, PT

MEDICARE: DR. KENYA LATRICE LAWSON DPT, PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistIA
2225100000XPhysical TherapistPT33180FL

General Provider Information

NPI Number : 1205349354
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENYA LATRICE LAWSON DPT, PT
Provider Business Mailing Address
First Line : 1313 CYPRESS AVE
Second Line :
City : SANFORD
State : FL
Zip : 32771-2921
Country : US
Telephone Number : 321-262-1796
Fax Number :
Provider Business Practice Location Address
First Line : 1700 3RD ST NE
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-2264
Country : US
Telephone Number : 319-334-7015
Fax Number : 319-334-7016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2017
Last Update Date : 11/13/2017

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