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General NPI Number Information
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NPI Number | 1457162265
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Entity Type | Individual
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Provider Name | LAURA ANNETTE PATTERSON
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Gender | Female
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 8701 RILEY DR
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6509
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Country | US
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Telephone | 501-224-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 122 ANCHUKA DR
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City | SALTILLO
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State | MS
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Zip | 38866-5790
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Country | US
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Telephone | 662-321-2095
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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 | PTA2217
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License Number State | MS
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