Provider Demographics
NPI:1154340529
Name:SCHELL, LAURA (PT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:SCHELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 EVANS MILL DR STE 206
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-1624
Mailing Address - Country:US
Mailing Address - Phone:678-909-9278
Mailing Address - Fax:833-264-6634
Practice Address - Street 1:110 EVANS MILL DR STE 206
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157
Practice Address - Country:US
Practice Address - Phone:678-909-9278
Practice Address - Fax:833-264-6634
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007562225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511I650056Medicare PIN