Basic Information
Provider Information
NPI: 1801975479
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BATCHELOR
FirstName: LAURIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 820 ROY ST
Address2:  
City: ORTONVILLE
State: MN
PostalCode: 562781138
CountryCode: US
TelephoneNumber: 3208394271
FaxNumber: 3208394196
Practice Location
Address1: 450 EASTVOLD AVE
Address2:  
City: ORTONVILLE
State: MN
PostalCode: 562781252
CountryCode: US
TelephoneNumber: 3208394150
FaxNumber: 3208394196
Other Information
ProviderEnumerationDate: 11/03/2006
LastUpdateDate: 03/25/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X6726MNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X1126SDN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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