Provider Demographics
NPI:1518266634
Name:CLAGETT, LAURA ANN (DPT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:CLAGETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:LUDEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 1241
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75151-1241
Mailing Address - Country:US
Mailing Address - Phone:903-874-7433
Mailing Address - Fax:903-874-6295
Practice Address - Street 1:1026 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-3702
Practice Address - Country:US
Practice Address - Phone:903-874-7433
Practice Address - Fax:903-874-6295
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1203958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist