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General NPI Number Information
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NPI Number | 1457547291
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Entity Type | Organization
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Legal Business Name | ERIC J. LAUDENSLAGER
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 1630 W REDLANDS BLVD L
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City | REDLANDS
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State | CA
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Zip | 92373-8032
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Country | US
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Telephone | 909-797-5155
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Fax | 909-797-2768
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Provider Business Mailing Address
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Address Line | 33492 OAK GLEN RD H
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City | YUCAIPA
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State | CA
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Zip | 92399-2096
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Country | US
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Telephone | 909-797-5155
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Fax | 909-797-2768
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Authorized Official
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Title or Position | PT/OWNER
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Name | ERIC LAUDENSLAGER
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Credential | M.P.T.
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Telephone | 909-797-5155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT8450
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License Number State | CA
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