Provider Demographics
NPI:1457917049
Name:FOLEY, LAURA D (PTA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:D
Last Name:FOLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:425 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9141
Mailing Address - Country:US
Mailing Address - Phone:717-646-3742
Mailing Address - Fax:
Practice Address - Street 1:425 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-9141
Practice Address - Country:US
Practice Address - Phone:717-646-3742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1002221225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant