Provider Demographics
NPI:1689624736
Name:ROBSON, LAURA REEVES (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:REEVES
Last Name:ROBSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:KATHERINE
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:311 JONESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2645
Mailing Address - Country:US
Mailing Address - Phone:864-380-6013
Mailing Address - Fax:
Practice Address - Street 1:319 MILLS AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4021
Practice Address - Country:US
Practice Address - Phone:864-233-1153
Practice Address - Fax:864-271-4487
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist