Provider Demographics
NPI:1962438085
Name:MCNALLY, LAURA DARBY (ATC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:DARBY
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-5210
Mailing Address - Country:US
Mailing Address - Phone:978-369-4688
Mailing Address - Fax:
Practice Address - Street 1:1400 LOWELL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-5210
Practice Address - Country:US
Practice Address - Phone:978-369-4688
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer