Provider Demographics
NPI:1831194273
Name:LANKFORD, LAURA N (PT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:N
Last Name:LANKFORD
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 1:2660 W MARKET ST
Mailing Address - Street 2:STE 300
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4206
Mailing Address - Country:US
Mailing Address - Phone:330-869-2635
Mailing Address - Fax:330-869-8315
Practice Address - Street 1:2660 W MARKET ST
Practice Address - Street 2:STE 300
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4206
Practice Address - Country:US
Practice Address - Phone:330-869-2635
Practice Address - Fax:330-869-8315
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT09384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSE4038691Medicare PIN