Laura Deboer, PT

Individual provider Active NPI Physical Therapist · Kent, CT

NPI 1154438729 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154438729
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
004720 (CT)
Practice address
64 Maple St
Kent, CT 06757-0034
Phone
(860) 927-4559
Fax
(860) 927-3352
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
004720CTMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004720 CT Yes

Addresses

Primary practice location

64 Maple St
Kent, CT 06757-0034

Mailing address

PO Box 34
Kent, CT 06757-0034
Phone (860) 927-4559

Other identifiers

IdentifierTypeStateIssuer
0800004720CT01OtherCTANTHEM BC/BS PROVIDER
437033OtherNYMVP PROVIDER
OV6316OtherCTHEALTH NET PROVIDER
15901OtherCTCIGNA ORTHONET PROVIDER
2288136OtherCTAETNA PROVIDER
64-04275OtherCTUNITED HEALTH CARE PROVID
P2057224OtherNYOXFORD OUR OF NETOWRK PRO
QB0381OtherNYEMPIRE BC/BS PROVIDER

Other providers in Kent, CT

All providers in Kent, CT · Physical Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.