Provider Demographics
NPI:1295994010
Name:MANFIELD-GOODRIDGE, LAURA (DO)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:MANFIELD-GOODRIDGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:MANFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:17 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2788
Practice Address - Country:US
Practice Address - Phone:413-549-8400
Practice Address - Fax:413-549-8409
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA257453208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation