Provider Demographics
NPI:1790952430
Name:SCHWARK, LAURA MARGRETTA (PT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARGRETTA
Last Name:SCHWARK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4339 JEAN AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5050
Mailing Address - Country:US
Mailing Address - Phone:919-622-1980
Mailing Address - Fax:
Practice Address - Street 1:229 FEARRINGTON POST
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-8555
Practice Address - Country:US
Practice Address - Phone:919-636-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist