Basic Information
| Provider Information | |||||||||
| NPI: | 1699033308 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPIEGEL | ||||||||
| FirstName: | LAWRENCE | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4300 AURORA AVE N | ||||||||
| Address2: | APT S402 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981037379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163766677 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1580 SAWGRASS CORPORATE PKWY | ||||||||
| Address2: | MEDPRO HEALTHCARE STAFFING SUITE 100 | ||||||||
| City: | SUNRISE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547394247 | ||||||||
| FaxNumber: | 8003700755 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2012 | ||||||||
| LastUpdateDate: | 01/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 32022 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT60265996 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.