Provider Demographics
NPI:1922478767
Name:GAITAN, LAFORIE (DPT)
Entity Type:Individual
Prefix:
First Name:LAFORIE
Middle Name:
Last Name:GAITAN
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 1:1850 M ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5803
Mailing Address - Country:US
Mailing Address - Phone:202-835-2222
Mailing Address - Fax:202-969-1798
Practice Address - Street 1:1850 M ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5803
Practice Address - Country:US
Practice Address - Phone:202-835-2222
Practice Address - Fax:202-969-1798
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT871884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist