Provider Demographics
NPI:1700407590
Name:BALDWIN, LAURA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 BAYLAUREL DR
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-4671
Mailing Address - Country:US
Mailing Address - Phone:678-677-6771
Mailing Address - Fax:
Practice Address - Street 1:500 LANIER AVE W STE 702
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7643
Practice Address - Country:US
Practice Address - Phone:678-884-5085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist