Provider Demographics
NPI:1417019126
Name:DANA, LAURA LYNN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:DANA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 KEARNEY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4550
Mailing Address - Country:US
Mailing Address - Phone:303-780-9763
Mailing Address - Fax:
Practice Address - Street 1:1139 KEARNEY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4550
Practice Address - Country:US
Practice Address - Phone:303-780-9763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist