Provider Demographics
NPI:1306881180
Name:CROWELL, LAURA LYNETTE (ATC, MS, NASM-PES)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LYNETTE
Last Name:CROWELL
Suffix:
Gender:F
Credentials:ATC, MS, NASM-PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 G ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2515
Mailing Address - Country:US
Mailing Address - Phone:507-532-0209
Mailing Address - Fax:507-537-6578
Practice Address - Street 1:1501 STATE ST
Practice Address - Street 2:BA 130B
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-3306
Practice Address - Country:US
Practice Address - Phone:507-537-6578
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer