Individual
LAURA CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
517 E NORTH ST, BRADLEY, IL 60915-1258
(815) 802-7503
(815) 802-7514
Mailing address
517 E NORTH ST, BRADLEY, IL 60915-1258
(815) 802-7503
(815) 802-7514
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.007954
IL
225700000X
Massage Therapist
227008895
IL
Other
Enumeration date
12/13/2017
Last updated
03/17/2018
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