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General NPI Number Information
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NPI Number | 1104227693
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Entity Type | Individual
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Provider Name | LAURA SHAW PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 1508 S 7TH ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-7498
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Country | US
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Telephone | 228-238-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 1508 S 7TH ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-7498
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Country | US
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Telephone | 228-238-2515
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 41109
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH6958
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9680
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7502
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License Number State | MS
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