MEDICARE: CHRISTINE LAPLANTE 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
1	225200000X	Physical Therapy Assistant	PT4016	ME
2	225200000X	Physical Therapy Assistant	8505	MA
3	225200000X	Physical Therapy Assistant	0970	NH

General Provider Information

NPI Number	:	1760736391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE LAPLANTE PTA

Provider Business Mailing Address
First Line	:	161 EASTERN AVE
Second Line	:	APT 302
City	:	MANCHESTER
State	:	NH
Zip	:	03104-4647
Country	:	US
Telephone Number	:	603-867-1270
Fax Number	:

Provider Business Practice Location Address
First Line	:	47 ELM ST
Second Line	:
City	:	NORTH BERWICK
State	:	ME
Zip	:	03906-6724
Country	:	US
Telephone Number	:	207-676-1301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2012
Last Update Date	:	11/05/2012

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