Provider Demographics
NPI:1386606226
Name:COLEMAN, LAURA (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:156 STRAWBERRY PLAINS RD STE B
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-3409
Practice Address - Country:US
Practice Address - Phone:757-565-3400
Practice Address - Fax:757-565-6445
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA192935OtherBCBS PHYSICAL THERAPY
7356624OtherAETNA
VA010140099Medicaid
VA7549457OtherAETNA
VAP00191307OtherMEDICARE RAILROAD
VAP00191307OtherMEDICARE RAILROAD
VAC05954Medicare PIN