Provider Demographics
NPI:1316615503
Name:MEURER, LAURA (PT, DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MEURER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:THEISEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14136 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-5717
Mailing Address - Country:US
Mailing Address - Phone:608-335-8976
Mailing Address - Fax:
Practice Address - Street 1:1925 WOODWINDS DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4445
Practice Address - Country:US
Practice Address - Phone:651-232-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist