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General NPI Number Information
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NPI Number | 1073837407
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Entity Type | Individual
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Provider Name | LAURA PFAFF PODYMA LPTA
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Gender | Female
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Dates
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Enumeration Date | 03/14/2010
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Last Update Date | 03/14/2010
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Provider Practice Location Address
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Address Line | 1225 HOSTA LN
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City | BEDFORD
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State | VA
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Zip | 24523-4976
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Country | US
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Telephone | 540-297-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 HOSTA LN
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City | BEDFORD
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State | VA
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Zip | 24523-4976
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Country | US
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Telephone | 540-297-7445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306001029
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License Number State | VA
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