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NPI Code Detail

MEDICARE: DEBORAH LAPORTE PTA

MEDICARE: DEBORAH LAPORTE PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2306602873VA

General Provider Information

NPI Number : 1386948701
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH LAPORTE PTA
Provider Business Mailing Address
First Line : 1628 OLD DONATION PKWY
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-3062
Country : US
Telephone Number : 757-496-3092
Fax Number : 757-496-2837
Provider Business Practice Location Address
First Line : 1628 OLD DONATION PKWY
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-3062
Country : US
Telephone Number : 757-496-3092
Fax Number : 757-496-2837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2010
Last Update Date : 12/28/2010

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Directions to “ DEBORAH LAPORTE PTA” Practice Location

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