MEDICARE: LAUREN ALONSO 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
1	225100000X	Physical Therapist	PT009524	GA
2	225100000X	Physical Therapist	PT24216	FL

General Provider Information

NPI Number	:	1225278344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ALONSO PT

Provider Business Mailing Address
First Line	:	1401 GEORGIAN PARK
Second Line	:	SUITE 120
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-6973
Country	:	US
Telephone Number	:	770-487-1931
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 GEORGIAN PARK
Second Line	:	SUITE 120
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-6973
Country	:	US
Telephone Number	:	770-487-1931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2009
Last Update Date	:	03/02/2009

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Directions to “ LAUREN ALONSO PT” Practice Location

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