Provider Demographics
NPI:1013927714
Name:APPLEGATE, LAURIE (RPT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:7088 UNIVERSITY CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-6992
Mailing Address - Country:US
Mailing Address - Phone:334-396-1400
Mailing Address - Fax:334-396-2727
Practice Address - Street 1:242 WINTON M BLOUNT LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3501
Practice Address - Country:US
Practice Address - Phone:334-279-5015
Practice Address - Fax:334-279-5028
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH 4223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51517955OtherBC/BS PROVIDER NUMBER
AL#54405Medicare UPIN