Provider Demographics
NPI:1407926025
Name:TURNER, LAURA GAYLE (PTA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:GAYLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 DEVONSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-2782
Mailing Address - Country:US
Mailing Address - Phone:937-667-8530
Mailing Address - Fax:
Practice Address - Street 1:813 DEVONSHIRE AVE
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2782
Practice Address - Country:US
Practice Address - Phone:937-667-8530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA 04028225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant