Provider Demographics
NPI:1215151188
Name:STONE, LAURA ELAINE (PT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ELAINE
Last Name:STONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9409 CHANTECLAIR DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-8679
Mailing Address - Country:US
Mailing Address - Phone:502-262-2009
Mailing Address - Fax:502-326-8992
Practice Address - Street 1:9409 CHANTECLAIR DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-8679
Practice Address - Country:US
Practice Address - Phone:502-262-2009
Practice Address - Fax:502-326-8992
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003836225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1121OtherFIRST STEPS PROVIDER NUMB