Provider Demographics
NPI:1497165088
Name:MERSLICH, LAURA ADAMS (PT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ADAMS
Last Name:MERSLICH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2586 NW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3456
Mailing Address - Country:US
Mailing Address - Phone:989-225-2652
Mailing Address - Fax:
Practice Address - Street 1:7431 W ATLANTIC AVE STE 52
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446
Practice Address - Country:US
Practice Address - Phone:561-638-7455
Practice Address - Fax:561-638-7873
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27550225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist