Provider Demographics
NPI:1548287998
Name:SUTER, LAURA C (MPT, CLT, CMT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:C
Last Name:SUTER
Suffix:
Gender:F
Credentials:MPT, CLT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10560 LIGON MILL ROAD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-556-4678
Mailing Address - Fax:919-556-4619
Practice Address - Street 1:1021 DARRINGTON DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513
Practice Address - Country:US
Practice Address - Phone:919-468-0955
Practice Address - Fax:919-468-5747
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5933225100000X
NCP5933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6697667OtherGHI
NC836303OtherACN MPN UHC
NC5293796OtherACN MPN UHC
NC07972OtherBCBS
NC2503771CMedicare ID - Type Unspecified