Provider Demographics
NPI:1033259668
Name:CHASE, LAURIEANN (LPTA)
Entity Type:Individual
Prefix:MISS
First Name:LAURIEANN
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-1303
Mailing Address - Country:US
Mailing Address - Phone:716-912-8681
Mailing Address - Fax:
Practice Address - Street 1:709 RICE AVENUE EXT
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-8613
Practice Address - Country:US
Practice Address - Phone:864-427-0306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1898225200000X
NY006127-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant