Healthcare Provider Details

I. General information

NPI: 1952603599
Provider Name (Legal Business Name): LAURA BETH TOWBIN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2010
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 S JOSEPHINE ST
DENVER CO
80210-2428
US

IV. Provider business mailing address

1414 S JOSEPHINE ST
DENVER CO
80210-2428
US

V. Phone/Fax

Practice location:
  • Phone: 615-351-6246
  • Fax:
Mailing address:
  • Phone: 615-351-6246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number9761
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: