Provider Demographics
NPI:1417020918
Name:LAURA ANN SAYLOR FLETT
Entity Type:Organization
Organization Name:LAURA ANN SAYLOR FLETT
Other - Org Name:YREKA PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SAYLOR FLETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:530-842-4381
Mailing Address - Street 1:PO BOX 1226
Mailing Address - Street 2:205 EXECUTIVE CT
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-1226
Mailing Address - Country:US
Mailing Address - Phone:530-842-4381
Mailing Address - Fax:530-842-3037
Practice Address - Street 1:205 EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-2629
Practice Address - Country:US
Practice Address - Phone:530-842-4381
Practice Address - Fax:530-842-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT 0092720Medicaid
PT0092720OtherRAILROAD MEDICARE NUMBER
171225700OtherOWCP
ZZZ266922Medicare PIN
171225700OtherOWCP