Provider Demographics
NPI:1861880486
Name:LAPORE, CHARITA (PT)
Entity type:Individual
Prefix:MRS
First Name:CHARITA
Middle Name:
Last Name:LAPORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14303 W ONEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67235-3441
Mailing Address - Country:US
Mailing Address - Phone:316-722-2295
Mailing Address - Fax:
Practice Address - Street 1:14303 W ONEWOOD ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67235-3441
Practice Address - Country:US
Practice Address - Phone:316-722-2295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist