Provider Demographics
NPI:1043025208
Name:BECHTOLD, LAURA LOUISE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LOUISE
Last Name:BECHTOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BABS LN
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-5721
Mailing Address - Country:US
Mailing Address - Phone:314-750-0452
Mailing Address - Fax:
Practice Address - Street 1:121 BABS LN
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-5721
Practice Address - Country:US
Practice Address - Phone:314-750-0452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist