Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 14-02227 | KS |
NPI | 1013200450 |
---|---|
Provider Name | Maura Lau |
First Address | Hutchinson, KS 67502-3970 |
Second Address | Hutchinson, KS 67502-2266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2011 |
Last Update Date | 18/05/2011 |