Provider Demographics
NPI:1083054522
Name:BALDWIN, LAURA (DPT)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BOONE AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1863
Mailing Address - Country:US
Mailing Address - Phone:859-230-1502
Mailing Address - Fax:
Practice Address - Street 1:314 HIGHLAND PARK DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3487
Practice Address - Country:US
Practice Address - Phone:859-353-5022
Practice Address - Fax:859-353-5047
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist