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General NPI Number Information
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NPI Number | 1255318465
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Entity Type | Individual
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Provider Name | LAURA B. REAGAN P.T.
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Gender | Female
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 601 W MAIN ST STE B
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City | BYRDSTOWN
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State | TN
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Zip | 38549-2418
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Country | US
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Telephone | 931-864-8090
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Fax | 931-864-8091
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Provider Business Mailing Address
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Address Line | PO BOX 368
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City | BYRDSTOWN
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State | TN
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Zip | 38549-0368
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Country | US
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Telephone | 931-864-8090
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Fax | 931-864-8091
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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 | PT0000006366
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License Number State | TN
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