Provider Demographics
NPI:1710179692
Name:CHAMBERLAIN, LAURA KATHLEEN (DPT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHLEEN
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9589 LINCOLN HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-3708
Mailing Address - Country:US
Mailing Address - Phone:814-623-9022
Mailing Address - Fax:814-623-6639
Practice Address - Street 1:9589 LINCOLN HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-3708
Practice Address - Country:US
Practice Address - Phone:814-623-9022
Practice Address - Fax:814-623-6639
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018793208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation