Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT009106E | PA |
N | 2251H1200X | Hand | PT009106E | PA |
NPI | 1457561409 |
---|---|
Provider Name | Mary Beth Laplant |
First Address | Philadelphia, PA 19107-5127 |
Second Address | Philadelphia, PA 19107-5127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2834559000 | IBC - KEYSTONE (01) | PA |