MEDICARE: TEOMA LASHAWN DPT

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	172M00000X	Mechanotherapist	871014	DC
2	225100000X	Physical Therapist	PT010423	GA
3	225100000X	Physical Therapist	36785	CA
4	225100000X	Physical Therapist	23069	NC

General Provider Information

NPI Number	:	1548490162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEOMA LASHAWN DPT

Provider Business Mailing Address
First Line	:	2080 DUKE UNIVERSITY RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-3191
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 DUKE HEALTH CARY PL
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-6759
Country	:	US
Telephone Number	:	855-855-6484
Fax Number	:

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

Provider Enumeration Date	:	07/16/2009
Last Update Date	:	08/05/2024

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