Provider Demographics
NPI:1508061763
Name:DYLUS, LAURA J (PT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:DYLUS
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 1:77 MORGAN BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9638
Mailing Address - Country:US
Mailing Address - Phone:828-777-1883
Mailing Address - Fax:828-585-2359
Practice Address - Street 1:38 ROSSCRAGGON RD STE B
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1165
Practice Address - Country:US
Practice Address - Phone:828-571-0440
Practice Address - Fax:828-585-2359
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9524225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0674UOtherBCBS PIN