Provider Demographics
NPI:1679301691
Name:BABB, LAURA HAWKINS (DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:HAWKINS
Last Name:BABB
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:580 FRIARS POINT RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-9734
Mailing Address - Country:US
Mailing Address - Phone:662-902-1388
Mailing Address - Fax:866-309-6521
Practice Address - Street 1:580 FRIARS POINT RD
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-9734
Practice Address - Country:US
Practice Address - Phone:662-902-1388
Practice Address - Fax:866-309-6521
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS5734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist