Provider Demographics
NPI:1841155876
Name:FOURNIER, LAUREL E
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:E
Last Name:FOURNIER
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 1:1175 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-2052
Mailing Address - Country:US
Mailing Address - Phone:508-367-0288
Mailing Address - Fax:
Practice Address - Street 1:130 NORTH ST STE D
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3825
Practice Address - Country:US
Practice Address - Phone:508-775-6685
Practice Address - Fax:508-771-5774
Is Sole Proprietor?:No
Enumeration Date:2025-12-22
Last Update Date:2025-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPTL89015208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation