Provider Demographics
NPI:1891090270
Name:DENVER, LAURA LYNN (PT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LYNN
Last Name:DENVER
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 1:790 MONTGOMERY HWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1872
Mailing Address - Country:US
Mailing Address - Phone:205-822-7607
Mailing Address - Fax:
Practice Address - Street 1:790 MONTGOMERY HWY
Practice Address - Street 2:SUITE 108
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-1872
Practice Address - Country:US
Practice Address - Phone:205-822-7607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist