Provider Demographics
NPI:1205083052
Name:REIMAN, LAURA FRANCES (PT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:FRANCES
Last Name:REIMAN
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 1:1201 NEWCASTLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-1243
Mailing Address - Country:US
Mailing Address - Phone:309-444-1065
Mailing Address - Fax:
Practice Address - Street 1:1201 NEWCASTLE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-1243
Practice Address - Country:US
Practice Address - Phone:309-444-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-23
Last Update Date:2008-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist