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NPI Code Detail

MEDICARE: KATHERINE LA RUE LAIN P.T.

MEDICARE:   KATHERINE LA RUE LAIN  P.T.
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
1225100000XPhysical Therapist1138543TX

General Provider Information

NPI Number : 1750551040
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE LA RUE LAIN P.T.
Provider Business Mailing Address
First Line : 300 LOOP 11
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76306-3705
Country : US
Telephone Number : 940-723-8420
Fax Number :
Provider Business Practice Location Address
First Line : 300 LOOP 11
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76306-3705
Country : US
Telephone Number : 940-723-8420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2008
Last Update Date : 03/03/2008

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Directions to “ KATHERINE LA RUE LAIN P.T.” Practice Location

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