Provider Demographics
NPI:1902059496
Name:LAWS, MARISA DANIELLE (PT)
Entity Type:Individual
Prefix:MISS
First Name:MARISA
Middle Name:DANIELLE
Last Name:LAWS
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 1:1932 ALCOA HWY.
Mailing Address - Street 2:SUITE G50 UNIVERSITY OF TN MEDICAL CENTER
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920
Mailing Address - Country:US
Mailing Address - Phone:865-305-6630
Mailing Address - Fax:865-305-6631
Practice Address - Street 1:1932 ALCOA HWY.
Practice Address - Street 2:SUITE G50
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-305-6630
Practice Address - Fax:865-305-6631
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist