Provider Demographics
NPI:1649502337
Name:DANBERG, LAURA ROSALIE (DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ROSALIE
Last Name:DANBERG
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 1:3 BETHESDA METRO CTR
Mailing Address - Street 2:SUITE B001
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-5330
Mailing Address - Country:US
Mailing Address - Phone:301-986-9252
Mailing Address - Fax:
Practice Address - Street 1:3 BETHESDA METRO CTR
Practice Address - Street 2:SUITE B001
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5330
Practice Address - Country:US
Practice Address - Phone:301-986-9252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23187225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist