Individual
LAURA E HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
750 CYPRESS STATION DR, LOUISVILLE, KY 40207-5142
(502) 897-6579
(502) 897-2725
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4914
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004677
KY
2251X0800X
Orthopedic Physical Therapist
004677
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004677
STATE LICENSE
KY
Enumeration date
11/22/2008
Last updated
12/07/2020
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