Provider Demographics
NPI:1194827774
Name:CUMMINGS, LAURA MARIE (PT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36861 ELIA CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3725
Mailing Address - Country:US
Mailing Address - Phone:248-797-4888
Mailing Address - Fax:
Practice Address - Street 1:5454 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-4636
Practice Address - Country:US
Practice Address - Phone:586-558-3600
Practice Address - Fax:586-558-3604
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI711060225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist