MEDICARE: ANTHONY LAURENTO JR. L.P.T

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
1	225100000X	Physical Therapist	PT007295L	PA

General Provider Information

NPI Number	:	1295918803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY LAURENTO JR. L.P.T

Provider Business Mailing Address
First Line	:	1117 NOBB HILL DR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-1884
Country	:	US
Telephone Number	:	610-692-0804
Fax Number	:

Provider Business Practice Location Address
First Line	:	1117 NOBB HILL DR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-1884
Country	:	US
Telephone Number	:	610-692-0804
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	09/29/2009

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