Provider Demographics
NPI:1497998827
Name:SKUTCH, LAURIE ANN (PT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:SKUTCH
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 1:514 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:PA
Mailing Address - Zip Code:15946-1626
Mailing Address - Country:US
Mailing Address - Phone:814-421-2754
Mailing Address - Fax:814-736-8039
Practice Address - Street 1:514 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:PA
Practice Address - Zip Code:15946-1626
Practice Address - Country:US
Practice Address - Phone:814-421-2754
Practice Address - Fax:814-736-8039
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013478L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist