Provider Demographics
NPI:1447275086
Name:STONE, LAURIE JASALYN (PT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:JASALYN
Last Name:STONE
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 1:403 STATE HIGHWAY 110 N
Mailing Address - Street 2:PO BOX 415
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-3109
Mailing Address - Country:US
Mailing Address - Phone:903-839-1000
Mailing Address - Fax:903-839-4000
Practice Address - Street 1:403 STATE HIGHWAY 110 N
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-3109
Practice Address - Country:US
Practice Address - Phone:903-839-1000
Practice Address - Fax:903-839-4000
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1136430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G7958Medicare ID - Type Unspecified