Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 0013795 | CO |
NPI | 1164717302 |
---|---|
Provider Name | Dr. Alexandra R Laura |
First Address | Greenwood Village, CO 80111-2808 |
Second Address | Wellesley, MA 02481-7523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 01/11/2016 |