Provider Demographics
NPI:1790082675
Name:RICHARDSON, LAURA ELIZABETH (DPT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ELIZABETH
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 32ND ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-3516
Mailing Address - Country:US
Mailing Address - Phone:205-731-2177
Mailing Address - Fax:205-731-2519
Practice Address - Street 1:720 32ND ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3516
Practice Address - Country:US
Practice Address - Phone:205-731-2177
Practice Address - Fax:205-731-2519
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH60652251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic