Provider Demographics
NPI:1013923887
Name:LAWSON, MICHAEL K (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:K
Last Name:LAWSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 S MARYLAND PARKWAY
Mailing Address - Street 2:STE 612
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109
Mailing Address - Country:US
Mailing Address - Phone:702-734-6114
Mailing Address - Fax:702-734-8457
Practice Address - Street 1:3121 S MARYLAND PARKWAY
Practice Address - Street 2:STE 612
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109
Practice Address - Country:US
Practice Address - Phone:702-734-6114
Practice Address - Fax:702-734-8457
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV101003Medicare ID - Type Unspecified