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NPI Code Detail

MEDICARE: LAURA ANN CUMMINGS P.T.A

MEDICARE: LAURA ANN CUMMINGS P.T.A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation PhysicianPTA.0014283CO

General Provider Information

NPI Number : 1215439351
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ANN CUMMINGS P.T.A
Provider Business Mailing Address
First Line : 4805 OLD POST CIR
Second Line :
City : BOULDER
State : CO
Zip : 80301-3966
Country : US
Telephone Number : 303-517-5471
Fax Number :
Provider Business Practice Location Address
First Line : 2445 E CACHE LA POUDRE ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-4812
Country : US
Telephone Number : 719-471-8700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2018
Last Update Date : 03/05/2018

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