Provider Demographics
NPI:1528370137
Name:HALBROOK, LAURA ASBRIDGE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:ASBRIDGE
Last Name:HALBROOK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JILL
Other - Last Name:ASBRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7065 AIRWAYS BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-5873
Mailing Address - Country:US
Mailing Address - Phone:662-349-8997
Mailing Address - Fax:662-349-8987
Practice Address - Street 1:7065 AIRWAYS BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-5873
Practice Address - Country:US
Practice Address - Phone:662-349-8997
Practice Address - Fax:662-349-8987
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT5004225100000X
TN8715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist