Provider Demographics
NPI:1801496872
Name:FUNK, LAURA A (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:FUNK
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 1:5005 S KIPLING PKWY STE A4
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1375
Mailing Address - Country:US
Mailing Address - Phone:303-274-7331
Mailing Address - Fax:720-497-6726
Practice Address - Street 1:5005 S KIPLING PKWY STE A4
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-1375
Practice Address - Country:US
Practice Address - Phone:303-274-7331
Practice Address - Fax:720-497-6726
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01965000225100000X
TN13821225100000X
GAPT015702225100000X
NCP20979225100000X
COCP013190T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist