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NPI Code Detail

MEDICARE: MS. LAURAN L ROCKWOOD MPT

MEDICARE:  MS. LAURAN L ROCKWOOD  MPT
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 Therapist2305006236VA

General Provider Information

NPI Number : 1407074982
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAURAN L ROCKWOOD MPT
Provider Business Mailing Address
First Line : 3288 PAGE AVE APT 1008
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-1036
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3288 PAGE AVE APT 1008
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-1036
Country : US
Telephone Number : 757-412-4152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/08/2007

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Directions to “ MS. LAURAN L ROCKWOOD MPT” Practice Location

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