Provider Demographics
NPI:1508876020
Name:LAWSON, DARYL JAY (PT, DPTSC)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:JAY
Last Name:LAWSON
Suffix:
Gender:M
Credentials:PT, DPTSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WMU UNIFIED CLINICS
Mailing Address - Street 2:1000 OAKLAND DR FL 3
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008
Mailing Address - Country:US
Mailing Address - Phone:269-387-7000
Mailing Address - Fax:269-387-7026
Practice Address - Street 1:WMU UNIFIED CLINICS
Practice Address - Street 2:1000 OAKLAND DR FL 3
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008
Practice Address - Country:US
Practice Address - Phone:269-387-7000
Practice Address - Fax:269-387-7026
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist