Healthcare Provider Details

I. General information

NPI: 1659938066
Provider Name (Legal Business Name): MARISA LAWS PT, DPT, PCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARISA WHITE PT, DPT, PCS

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7532 WILKINS DR
FAYETTEVILLE NC
28311-9338
US

IV. Provider business mailing address

7532 WILKINS DR
FAYETTEVILLE NC
28311-9338
US

V. Phone/Fax

Practice location:
  • Phone: 910-868-6000
  • Fax: 866-475-8361
Mailing address:
  • Phone: 910-868-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9989
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP18826
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberP18826
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: