Provider Demographics
NPI:1548426059
Name:FLEMING, LAURA G (PT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:G
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:G
Other - Last Name:KEPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2301 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-9540
Mailing Address - Country:US
Mailing Address - Phone:484-526-5040
Mailing Address - Fax:
Practice Address - Street 1:231 GRANITE RUN DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-735-3600
Practice Address - Fax:717-735-3604
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0194162251X0800X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA130591D1XMedicare PIN