Provider Demographics
NPI:1336928795
Name:LAWSON, DAVID (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LAWSON
Suffix:
Gender:M
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 1:4721 DILLINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4738
Mailing Address - Country:US
Mailing Address - Phone:317-750-3408
Mailing Address - Fax:
Practice Address - Street 1:107 EDINBURGH SOUTH DR STE 100A
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6455
Practice Address - Country:US
Practice Address - Phone:919-678-3286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05015224A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist