Healthcare Provider Details

I. General information

NPI: 1881728582
Provider Name (Legal Business Name): LAURIE M BREGITZER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4480 WHITNEY RD
WESTFIELD IN
46062-6814
US

IV. Provider business mailing address

4480 WHITNEY RD
WESTFIELD IN
46062-6814
US

V. Phone/Fax

Practice location:
  • Phone: 317-804-5952
  • Fax:
Mailing address:
  • Phone: 317-804-5952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06004301A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: