Provider Demographics
NPI:1740381979
Name:CUMMING, LAURIE K (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:K
Last Name:CUMMING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LAURIE
Other - Middle Name:KAY
Other - Last Name:KRIEBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2501 PILLOW CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454
Mailing Address - Country:US
Mailing Address - Phone:757-481-5461
Mailing Address - Fax:757-459-2421
Practice Address - Street 1:839 POPLAR HALL DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502
Practice Address - Country:US
Practice Address - Phone:757-459-2112
Practice Address - Fax:757-459-2421
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305001885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA192433OtherBC
VA003263P38Medicare ID - Type Unspecified