Provider Demographics
NPI:1962556910
Name:HIGGINS, LAURA LEE (PT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:BILODEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:575 DEKALB INDUSTRIAL WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1756
Mailing Address - Country:US
Mailing Address - Phone:404-296-8511
Mailing Address - Fax:404-296-8514
Practice Address - Street 1:575 DEKALB INDUSTRIAL WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1756
Practice Address - Country:US
Practice Address - Phone:404-296-8511
Practice Address - Fax:404-296-8514
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007599225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist