Provider Demographics
NPI:1164717302
Name:LAURA, ALEXANDRA R (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:R
Last Name:LAURA
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 1:8200 E BELLEVIEW AVE
Mailing Address - Street 2:STE 615
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2808
Mailing Address - Country:US
Mailing Address - Phone:781-237-5585
Mailing Address - Fax:781-237-5633
Practice Address - Street 1:2 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-7523
Practice Address - Country:US
Practice Address - Phone:781-237-5585
Practice Address - Fax:781-237-5633
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00137952251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports