MEDICARE: MRS. KELLIE LAPLANT 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
1	225100000X	Physical Therapist	PTH4172	AL

General Provider Information

NPI Number	:	1861496713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLIE LAPLANT P.T.

Provider Business Mailing Address
First Line	:	4 OFFICE PARK CIR
Second Line	:	SUITE 103
City	:	BIRMINGHAM
State	:	AL
Zip	:	35223-2511
Country	:	US
Telephone Number	:	205-871-7242
Fax Number	:	205-871-7240

Provider Business Practice Location Address
First Line	:	4198 US HIGHWAY 431
Second Line	:	SUITE D
City	:	ALBERTVILLE
State	:	AL
Zip	:	35950-0238
Country	:	US
Telephone Number	:	256-894-3870
Fax Number	:	256-894-3872

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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