Individual
MRS. LAURA DEBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
64 MAPLE ST, KENT, CT 06757-0034
(860) 927-4559
(860) 927-3352
Mailing address
PO BOX 34, KENT, CT 06757-0034
(860) 927-4559
(860) 927-3352
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004720
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800004720CT01
ANTHEM BC/BS PROVIDER
CT
01
—
15901
CIGNA ORTHONET PROVIDER
CT
01
—
2288136
AETNA PROVIDER
CT
01
—
437033
MVP PROVIDER
NY
01
—
64-04275
UNITED HEALTH CARE PROVID
CT
01
—
OV6316
HEALTH NET PROVIDER
CT
01
—
P2057224
OXFORD OUR OF NETOWRK PRO
NY
01
—
QB0381
EMPIRE BC/BS PROVIDER
NY
Enumeration date
08/23/2006
Last updated
07/08/2007
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