Doctor Name: | MISS LAUREN DIANE WENTWORTH |
NPI Number: | 1982770327 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHYSICAL THERAPIST |
License Number: | PT007711 |
Business Practice Address: | 536 Grand Slam Dr Evans, GA - 308098014 |
Business Phone Number: | 7068548434 |
Business Fax Number: | 7068548435 |
Mailing Address: | 1108 Waltons Pass, EVANS |
State: | GA |
Postal Code: | 308098247 |
Phone Number: | 7068686574 |
Fax Number: | |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT007711 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | GA |
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 |