Provider Demographics
NPI:1124030945
Name:MCCOY, LAUIRE (LMT)
Entity Type:Individual
Prefix:
First Name:LAUIRE
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 BEE RIDGE RD
Mailing Address - Street 2:STE E 3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1538
Mailing Address - Country:US
Mailing Address - Phone:941-379-3632
Mailing Address - Fax:941-379-8089
Practice Address - Street 1:5550 BEE RIDGE RD
Practice Address - Street 2:STE E 3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1538
Practice Address - Country:US
Practice Address - Phone:941-379-3632
Practice Address - Fax:941-379-8089
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 41299174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist