Provider Demographics
NPI:1093053985
Name:SIMENSON, LAURA A (DPT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:SIMENSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 W ASH ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4677
Mailing Address - Country:US
Mailing Address - Phone:970-561-7111
Mailing Address - Fax:970-561-7112
Practice Address - Street 1:1230 W ASH ST UNIT A
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4677
Practice Address - Country:US
Practice Address - Phone:970-561-7111
Practice Address - Fax:970-561-7112
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0012102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist