| Doctor Name: | LAURA JEAN WIDDOWS |
| NPI Number: | 1245317361 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPT |
| License Number: | 5501011710 |
| Business Practice Address: | 46401 Romeo Plank Rd Suite 5 Macomb, MI - 480443510 |
| Business Phone Number: | 5864162000 |
| Business Fax Number: | |
| Mailing Address: | 25311 Little Mack Ave, Suite A SAINT CLAIR SHORES |
| State: | MI |
| Postal Code: | 480813370 |
| Phone Number: | 5867714900 |
| Fax Number: | 5867714993 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501011710 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |