Provider Demographics
NPI:1245266436
Name:HAMMONTREE, LAURI SWALLOW (PT)
Entity type:Individual
Prefix:
First Name:LAURI
Middle Name:SWALLOW
Last Name:HAMMONTREE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAURI
Other - Middle Name:NICOLE
Other - Last Name:SWALLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1908 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6031
Mailing Address - Country:US
Mailing Address - Phone:256-340-9708
Mailing Address - Fax:256-340-9624
Practice Address - Street 1:11186 AL HIGHWAY 157
Practice Address - Street 2:SUITE B
Practice Address - City:MOULTON
Practice Address - State:AL
Practice Address - Zip Code:35650-1908
Practice Address - Country:US
Practice Address - Phone:256-905-7295
Practice Address - Fax:256-905-7291
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529917620Medicaid
AL1003819608OtherFROUP NPI
AL1003819608OtherFROUP NPI