Provider Demographics
NPI:1952604076
Name:WEBBER, LAURA JANE (RMT, CNMT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JANE
Last Name:WEBBER
Suffix:
Gender:F
Credentials:RMT, CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 SPRINGMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3740
Mailing Address - Country:US
Mailing Address - Phone:719-660-0368
Mailing Address - Fax:
Practice Address - Street 1:2020 W COLORADO AVE STE 103A
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3863
Practice Address - Country:US
Practice Address - Phone:719-660-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11259172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist