Provider Demographics
NPI:1992739940
Name:SIRRINE, LAURA A (ATC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:SIRRINE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:GOLOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1455 BROWNLEAF DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 HIOAKS RD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4061
Practice Address - Country:US
Practice Address - Phone:804-560-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260006412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer