Provider Demographics
NPI:1043601750
Name:BEEMAN-DEMAYO, LAURIE ANN (PT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:BEEMAN-DEMAYO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LAURIE
Other - Middle Name:ANN
Other - Last Name:BEEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:336 BLOOMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3271
Mailing Address - Country:US
Mailing Address - Phone:814-269-2224
Mailing Address - Fax:814-269-4587
Practice Address - Street 1:336 BLOOMFIELD ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3271
Practice Address - Country:US
Practice Address - Phone:814-269-2224
Practice Address - Fax:814-269-4587
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010716L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist