Basic Information
Provider Information
NPI: 1811008485
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MIEAR
FirstName: LAURA
MiddleName: KAY
NamePrefix:  
NameSuffix:  
Credential: OCCUPATIONAL THERAPI
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BARBRE
OtherFirstName: LAURA
OtherMiddleName: KAY
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: OCCUPATIONAL THERAPI
OtherLastNameType: 1
Mailing Information
Address1: 342 VIRGINIA AVE
Address2: HEARTLAND REHABILITATION SERVICES
City: WYTHEVILLE
State: VA
PostalCode: 24382
CountryCode: US
TelephoneNumber: 2762286200
FaxNumber: 2762289175
Practice Location
Address1: 5286 ALEXANDER RD
Address2: HEARTLAND REHABILITATION SERVICES
City: DUBLIN
State: VA
PostalCode: 24084
CountryCode: US
TelephoneNumber: 5406746400
FaxNumber: 5406746055
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X0119004002VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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