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General NPI Number Information
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NPI Number | 1942533757
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Entity Type | Individual
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Provider Name | KATHERINE LYNN LAUDER MS, PT
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Gender | Female
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Dates
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Enumeration Date | 09/10/2009
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Last Update Date | 09/10/2009
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Provider Practice Location Address
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Address Line | 37 BELMONT ST
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City | BROCKTON
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State | MA
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Zip | 02301-5299
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Country | US
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Telephone | 978-453-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 530 PLEASANT ST
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City | LEICESTER
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State | MA
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Zip | 01524-1239
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Country | US
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Telephone | 508-523-6808
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 18790
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License Number State | MA
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