Healthcare Provider Details

I. General information

NPI: 1548490162
Provider Name (Legal Business Name): TEOMA LASHAWN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TEOMA L LOEB DPT

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DUKE HEALTH CARY PL
CARY NC
27519-6759
US

IV. Provider business mailing address

2080 DUKE UNIVERSITY RD
DURHAM NC
27705-3191
US

V. Phone/Fax

Practice location:
  • Phone: 855-855-6484
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT010423
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number36785
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number23069
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number871014
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: