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General NPI Number Information
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NPI Number | 1447325238
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Entity Type | Individual
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Provider Name | LAURA ELLEN REGENER ATC
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 NEW SCHOOL LN
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City | DALLASTOWN
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State | PA
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Zip | 17313-9242
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Country | US
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Telephone | 717-244-4021
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Fax | 717-244-8813
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Provider Business Mailing Address
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Address Line | 1135 IRVING AVE.
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City | YORK
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State | PA
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Zip | 17403
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Country | US
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Telephone | 717-848-2227
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT003592
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License Number State | PA
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