Provider Demographics
NPI:1497814230
Name:DAWSON, LAURA LEE (PT, GCS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:PT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 INTERNATIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1130
Mailing Address - Country:US
Mailing Address - Phone:408-972-3506
Mailing Address - Fax:408-972-6415
Practice Address - Street 1:270 INTERNATIONAL CIR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1130
Practice Address - Country:US
Practice Address - Phone:408-972-3506
Practice Address - Fax:408-972-6415
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 21238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist