MEDICARE: LAURA HOGUE 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
1	225100000X	Physical Therapist	38879	CA

General Provider Information

NPI Number	:	1417223652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA HOGUE MPT

Provider Business Mailing Address
First Line	:	5214 E LOS ALTOS PLZ
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4251
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5214 E LOS ALTOS PLZ
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4251
Country	:	US
Telephone Number	:	562-597-3035
Fax Number	:

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

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	04/01/2015

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Directions to “ LAURA HOGUE MPT” Practice Location

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