Provider Demographics
NPI:1639426323
Name:ST. LAWRENCE, MARGARET (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:ST. LAWRENCE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:WESSEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:270 INTERNATIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1130
Mailing Address - Country:US
Mailing Address - Phone:908-418-3226
Mailing Address - Fax:
Practice Address - Street 1:5585 N CROATAN HWY
Practice Address - Street 2:
Practice Address - City:KITTY HAWK
Practice Address - State:NC
Practice Address - Zip Code:27949-3996
Practice Address - Country:US
Practice Address - Phone:252-261-1556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01454100225100000X
CA297923225100000X
NCP22675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist