Provider Demographics
NPI:1659022986
Name:CHRISTENSEN, LAURA (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:STANDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:23 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-8763
Mailing Address - Country:US
Mailing Address - Phone:804-912-4357
Mailing Address - Fax:
Practice Address - Street 1:212 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-2029
Practice Address - Country:US
Practice Address - Phone:804-912-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARTO0002712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer