Provider Demographics
NPI:1962176883
Name:LAIRD, LANDRY (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LANDRY
Middle Name:
Last Name:LAIRD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LANDRY
Other - Middle Name:
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1748 N WHISTLING STRAITS AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6686
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2070 MCKENZIE RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0747
Practice Address - Country:US
Practice Address - Phone:479-750-7778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist