Provider Demographics
NPI:1609092287
Name:SKEETERS, LAURA KRISTIN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:KRISTIN
Last Name:SKEETERS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9449 IMPERIAL HWY
Mailing Address - Street 2:PHYSICAL THERAPY DEPT., GARDEN MEDICAL OFFICE,3RD FLOOR
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2814
Mailing Address - Country:US
Mailing Address - Phone:562-657-2892
Mailing Address - Fax:
Practice Address - Street 1:9449 IMPERIAL HWY
Practice Address - Street 2:PM&R GARDEN 3RD FLOOR
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2814
Practice Address - Country:US
Practice Address - Phone:562-657-2823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26849225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist