Provider Demographics
NPI:1477691871
Name:BRAUN, LAURA M (MSPT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:BRAUN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 W OAK ST.
Mailing Address - Street 2:SUITE D
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715
Mailing Address - Country:US
Mailing Address - Phone:406-587-8446
Mailing Address - Fax:406-587-0898
Practice Address - Street 1:1707 W OAK
Practice Address - Street 2:SUITE D
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:406-587-8446
Practice Address - Fax:406-587-0898
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1559225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3400153Medicaid
MT61048OtherBCBS
MTMSF1220985OtherSTATE FUND
MTMSF1220985OtherSTATE FUND