Provider Demographics
NPI:1942556295
Name:GLAZEBROOK, LAURA DUNNING (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:DUNNING
Last Name:GLAZEBROOK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 MCCLURE BRIDGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-6675
Mailing Address - Country:US
Mailing Address - Phone:678-856-7550
Mailing Address - Fax:855-655-5261
Practice Address - Street 1:3400 MCCLURE BRIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-6675
Practice Address - Country:US
Practice Address - Phone:678-856-7550
Practice Address - Fax:855-655-5261
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010672225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic