| Doctor Name: | MRS. LAURA ANNE THEUNISSE |
| NPI Number: | 1629317987 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | P10953 |
| Business Practice Address: | 13635 Providence Rd Weddington, NC - 28104 |
| Business Phone Number: | 7044570043 |
| Business Fax Number: | 7048140224 |
| Mailing Address: | 8832 Blakeney Professional Dr, Suite 100 CHARLOTTE |
| State: | NC |
| Postal Code: | 282776809 |
| Phone Number: | 7048176718 |
| Fax Number: | 7048177887 |
| NPI Enumeration Date: | 02/06/2013 |
| NPI Last Update Date: | 09/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | P10953 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |