Healthcare Provider Details

I. General information

NPI: 1861496713
Provider Name (Legal Business Name): KELLIE LAPLANT P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4198 US HIGHWAY 431 SUITE D
ALBERTVILLE AL
35950-0238
US

IV. Provider business mailing address

4 OFFICE PARK CIR SUITE 103
BIRMINGHAM AL
35223-2511
US

V. Phone/Fax

Practice location:
  • Phone: 256-894-3870
  • Fax: 256-894-3872
Mailing address:
  • Phone: 205-871-7242
  • Fax: 205-871-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH4172
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: