Provider Demographics
NPI:1982856019
Name:DORRITY, LAURA MOSELEY (PT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MOSELEY
Last Name:DORRITY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 BALL CAMP PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-3313
Mailing Address - Country:US
Mailing Address - Phone:865-524-1234
Mailing Address - Fax:865-524-2169
Practice Address - Street 1:4307 BALL CAMP PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-3313
Practice Address - Country:US
Practice Address - Phone:865-524-1234
Practice Address - Fax:865-524-2169
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10678225100000X
NCP12952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist