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Individual

LAURA JO HARDEBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
19501
CA
225100000X
Physical Therapist
Primary
2356
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0257960
WASHINGTON L& I
01
0328996
WA L&I
OR
05
052154
OR
01
P00022831
RR MEDICARE PTAN
OR
Enumeration date
03/01/2006
Last updated
01/12/2021
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