Provider Demographics
NPI:1437548500
Name:CHEVREAUX, LAURA (PT, WCC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CHEVREAUX
Suffix:
Gender:F
Credentials:PT, WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4206
Mailing Address - Country:US
Mailing Address - Phone:530-906-2232
Mailing Address - Fax:
Practice Address - Street 1:885 S HIGHWAY 50 BUSINESS LOOP
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:CO
Practice Address - Zip Code:81425
Practice Address - Country:US
Practice Address - Phone:530-906-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1407225100000X
CO0015426225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist