Individual
LAURA E HUMPHREY
Active
Individual
LAURA E HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
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
Update your record
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