Individual
MS. LAURIE JENNIFER MOTTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4308 MESA DR, DENTON, TX 76207-3459
(940) 381-1501
(940) 591-7830
Mailing address
4401 N INTERSTATE 35 UNIT 312, DENTON, TX 76207-3318
(940) 381-1501
(940) 591-7830
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4351
AZ
363AM0700X
Medical Physician Assistant
085-002366
IL
363AM0700X
Medical Physician Assistant
Primary
PA07844
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429843
—
AZ
Enumeration date
03/27/2007
Last updated
03/29/2023
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