Provider Demographics
NPI:1477062420
Name:KORATSIS, LAURA HUFF (LMT, CHT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:HUFF
Last Name:KORATSIS
Suffix:
Gender:F
Credentials:LMT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5267 WOLF RUN RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:NY
Mailing Address - Zip Code:14821-9000
Mailing Address - Country:US
Mailing Address - Phone:607-425-4445
Mailing Address - Fax:
Practice Address - Street 1:204 W WATER ST
Practice Address - Street 2:
Practice Address - City:PAINTED POST
Practice Address - State:NY
Practice Address - Zip Code:14870-1131
Practice Address - Country:US
Practice Address - Phone:607-425-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019043225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist