Provider Demographics
NPI:1053604504
Name:NOLLSCH, LAURA COLLINS (MPT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:COLLINS
Last Name:NOLLSCH
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1282 ADAMS STREET
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3418
Mailing Address - Country:US
Mailing Address - Phone:303-393-1104
Mailing Address - Fax:
Practice Address - Street 1:1282 ADAMS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-3418
Practice Address - Country:US
Practice Address - Phone:303-393-1104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist