Laura L Douthit, PTA

Individual provider Active NPI Physical Therapy Assistant · Bridgeport, NE

NPI 1215367255 · NPPES record last updated Nov 12, 2013

Key facts

NPI
1215367255
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
185 (NE)
Practice address
10133 Road 94a
Bridgeport, NE 69336-5038
Phone
(308) 279-0206
NPI assigned
Nov 12, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
185NEMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 185 NE Yes

Addresses

Primary practice location

10133 Road 94a
Bridgeport, NE 69336-5038

Mailing address

10133 Road 94a
Bridgeport, NE 69336-5038
Phone (308) 279-0206

Other providers in Bridgeport, NE

All providers in Bridgeport, NE · Physical Therapy Assistant in Nebraska

Sources for this page

Verify at the official NPI Registry.