Provider Demographics
NPI:1447588538
Name:DONLAN, LAURA BARRETT (PT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BARRETT
Last Name:DONLAN
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 1:9368 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4610
Mailing Address - Country:US
Mailing Address - Phone:248-363-2115
Mailing Address - Fax:248-363-2308
Practice Address - Street 1:8896 COMMERCE RD STE 1
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-4494
Practice Address - Country:US
Practice Address - Phone:248-363-2115
Practice Address - Fax:248-363-2308
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032164174400000X
MI5501019532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist