Provider Demographics
NPI:1700035417
Name:MORROW, LAURA LEA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEA
Last Name:MORROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1392 MERRIMAC RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:IA
Mailing Address - Zip Code:52654-9523
Mailing Address - Country:US
Mailing Address - Phone:319-217-0876
Mailing Address - Fax:
Practice Address - Street 1:9950 PRINCESS PALM AVE
Practice Address - Street 2:SUITE 232
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-8302
Practice Address - Country:US
Practice Address - Phone:813-630-9000
Practice Address - Fax:813-630-4248
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004030796225200000X
IA00619225200000X
GAPTA002198225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant