Provider Demographics
NPI:1114298619
Name:DORSEY, LAURA LOONEY (DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LOONEY
Last Name:DORSEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3283 MALCOLM DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-8816
Mailing Address - Country:US
Mailing Address - Phone:334-356-1111
Mailing Address - Fax:334-356-9873
Practice Address - Street 1:3283 MALCOLM DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-8816
Practice Address - Country:US
Practice Address - Phone:334-356-1111
Practice Address - Fax:334-356-9873
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-16
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH5469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL225100000XOtherTAXONOMY