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General NPI Number Information
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NPI Number | 1205409943
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Entity Type | Individual
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Provider Name | LAURA ELIZABETH ERB DPT
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 300 EDWARDSVILLE RD STE 1&2
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City | TROY
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State | IL
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Zip | 62294-1437
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Country | US
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Telephone | 618-667-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 3944 SHENANDOAH AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63110-4016
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Country | US
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Telephone | 314-808-1990
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2021027210
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License Number State | MO
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