Provider Demographics
NPI:1487647707
Name:FIELDS, LAURA C (PT, ATC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:FIELDS
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-7699
Mailing Address - Country:TR
Mailing Address - Phone:907-488-4978
Mailing Address - Fax:907-488-4976
Practice Address - Street 1:PSC 94 BOX 2219
Practice Address - Street 2:
Practice Address - City:APO AE
Practice Address - State:INCIRLIK
Practice Address - Zip Code:09824
Practice Address - Country:TR
Practice Address - Phone:850-319-2259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 85322251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports