Provider Demographics
NPI:1528149226
Name:THROOP, LAURA T (CTRS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:T
Last Name:THROOP
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 BOARDMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-2727
Mailing Address - Country:US
Mailing Address - Phone:228-523-5038
Mailing Address - Fax:
Practice Address - Street 1:2106 BOARDMAN BLVD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-2727
Practice Address - Country:US
Practice Address - Phone:228-523-5038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist