Provider Demographics
NPI:1427287333
Name:STEWART, LAURA (PT, DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:FAZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:844 WASHINGTON RD STE 101
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-876-5600
Practice Address - Fax:410-876-1623
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist