Provider Demographics
NPI:1710267885
Name:LAWLEY, MEGAN BORRUANO (MPT)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:BORRUANO
Last Name:LAWLEY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LOUISE
Other - Last Name:BORRUANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:25550 JUBAN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6149
Mailing Address - Country:US
Mailing Address - Phone:225-665-8600
Mailing Address - Fax:225-665-6009
Practice Address - Street 1:25550 JUBAN RD
Practice Address - Street 2:SUITE B
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-6149
Practice Address - Country:US
Practice Address - Phone:225-665-8600
Practice Address - Fax:225-665-6009
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist