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Individual

MRS. CREE MATTHEWS LAUSE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
415 WAVERLY DR, AUGUSTA, GA 30909-3151
(706) 738-9885
Mailing address
415 WAVERLY DR, AUGUSTA, GA 30909-3151
(706) 738-9885

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001422
GA
225100000X
Physical Therapist
702
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
THO411
SC
Enumeration date
06/23/2006
Last updated
07/09/2007
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