Provider Demographics
NPI:1699033308
Name:SPIEGEL, LAWRENCE (DPT)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:SPIEGEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 AURORA AVE N
Mailing Address - Street 2:APT S402
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7379
Mailing Address - Country:US
Mailing Address - Phone:516-376-6677
Mailing Address - Fax:
Practice Address - Street 1:1580 SAWGRASS CORPORATE PKWY
Practice Address - Street 2:MEDPRO HEALTHCARE STAFFING SUITE 100
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323
Practice Address - Country:US
Practice Address - Phone:954-739-4247
Practice Address - Fax:800-370-0755
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32022225100000X
WAPT60265996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist