1669773891 NPI NUMBER - MRS. LAURA JERORE, MPT
Summary
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NPI Number |
1669773891 |
| Entity Type Code |
Individual |
| Provider Legal Name |
MRS. LAURA JERORE, MPT |
| Provider Business Practice Location Address |
2300 HAGGERTY RD
1110
WEST BLOOMFIELD, MI
ZIP 48323
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| Practice Location Phone Number |
(248) 669-2000 |
| Provider Taxonomy Code |
225100000X - Physical Therapist |
| Specialization |
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| Provider Enumeration Date |
11/4/2010 |
| Last Update Date |
11/4/2010 |
NPI Number 1669773891 is assigned to an individual registered under the provider name MRS. LAURA JERORE, MPT .
The NPPES NPI record indicates the provider is a female.
The provider is physically located at:
2300 HAGGERTY RD
1110
WEST BLOOMFIELD, MI
ZIP 48323-184
Phone: (248) 669-2000
Fax: (248) 669-2110
The enumeration date for this NPI number is 11/4/2010 and was last updated on 11/4/2010 .
Map - Location of Practice
Taxonomy Codes
The following information regarding the scope of practice of this provider is available:
Other (Legacy) Identifiers
The following legacy identifiers for this provider are available:
NPI Record
| 1 |
NPI |
1669773891 |
| 2 |
Entity Type Code |
1 |
| 3 |
Provider Last Name Legal Name |
JERORE |
| 4 |
Provider First Name |
LAURA |
| 5 |
Provider Name Prefix Text |
MRS. |
| 6 |
Provider Credential Text |
MPT |
| 7 |
Provider First Line Business Practice Location Address |
2300 HAGGERTY RD |
| 8 |
Provider Second Line Business Practice Location Address |
1110 |
| 9 |
Provider Business Practice Location Address City Name |
WEST BLOOMFIELD |
| 10 |
Provider Business Practice Location Address State Name |
MI |
| 11 |
Provider Business Practice Location Address Postal Code |
483232184 |
| 12 |
Provider Business Practice Location Address Country Code If outside U S |
US |
| 13 |
Provider Business Practice Location Address Telephone Number |
2486692000 |
| 14 |
Provider Business Practice Location Address Fax Number |
2486692110 |
| 15 |
Provider Enumeration Date |
11/4/2010 |
| 16 |
Last Update Date |
11/4/2010 |
| 17 |
Provider Gender Code |
F |
| 18 |
Healthcare Provider Taxonomy Code 1 |
225100000X |
| 19 |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
| 20 |
Is Sole Proprietor |
Y |
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This page was last updated on: 5/14/2013
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.