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NPI Code Detail

MEDICARE: MRS. CAROLYN M LAWSON PT

MEDICARE:  MRS. CAROLYN M LAWSON  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
1225100000XPhysical Therapist003709GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1650016944OTHERGAMEDICARE RAILROAD

General Provider Information

NPI Number : 1104000439
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLYN M LAWSON PT
Provider Business Mailing Address
First Line : 1163 JOHNSON FERRY RD
Second Line : SUITE 100
City : MARIETTA
State : GA
Zip : 30068-2764
Country : US
Telephone Number : 770-321-0155
Fax Number : 770-321-8426
Provider Business Practice Location Address
First Line : 1163 JOHNSON FERRY RD
Second Line : SUITE 100
City : MARIETTA
State : GA
Zip : 30068-2764
Country : US
Telephone Number : 770-321-0155
Fax Number : 770-321-8426
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2007
Last Update Date : 09/11/2008

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Directions to “ MRS. CAROLYN M LAWSON PT” Practice Location

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