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NPI Code Detail

MEDICARE: LAURA LAFFOND PT

MEDICARE: LAURA LAFFOND PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2305203786VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100567OTHERVAANTHEM

General Provider Information

NPI Number : 1124089941
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA LAFFOND PT
Provider Business Mailing Address
First Line : 3040 BERKMAR DR
Second Line : STE A1
City : CHARLOTTESVILLE
State : VA
Zip : 22901-1593
Country : US
Telephone Number : 434-465-1350
Fax Number : 434-964-0072
Provider Business Practice Location Address
First Line : 3040 BERKMAR DR STE A1
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22901-1593
Country : US
Telephone Number : 434-249-9578
Fax Number : 434-218-1486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2006
Last Update Date : 01/22/2020

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Directions to “ LAURA LAFFOND PT” Practice Location

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