Provider Demographics
NPI:1518259472
Name:BANDY, LAURA JOSEPHINE
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JOSEPHINE
Last Name:BANDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 YORI AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4325
Mailing Address - Country:US
Mailing Address - Phone:775-329-0312
Mailing Address - Fax:
Practice Address - Street 1:2725 YORI AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4325
Practice Address - Country:US
Practice Address - Phone:775-329-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner