Provider Demographics
NPI:1760561039
Name:BEEBE, LAURA U (MPT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:U
Last Name:BEEBE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:DIANE
Other - Last Name:UNVERZAGT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:10039 BALTIMORE NATIONAL PIKE STE L
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4044
Practice Address - Country:US
Practice Address - Phone:410-988-4319
Practice Address - Fax:410-844-0289
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist