Provider Demographics
NPI:1356816938
Name:BEECHER, LAURYN MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:MARIE
Last Name:BEECHER
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 1:316 E SILVER SPRING DR STE 227
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53217-5223
Mailing Address - Country:US
Mailing Address - Phone:414-214-3474
Mailing Address - Fax:
Practice Address - Street 1:316 E SILVER SPRING DR STE 227
Practice Address - Street 2:
Practice Address - City:WHITEFISH BAY
Practice Address - State:WI
Practice Address - Zip Code:53217-5223
Practice Address - Country:US
Practice Address - Phone:414-214-3474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1454324225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist