Provider Demographics
NPI:1538256235
Name:PENRITH, LAURA F (MPT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:F
Last Name:PENRITH
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 COBBLESTONE CT
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-7123
Mailing Address - Country:US
Mailing Address - Phone:319-266-7854
Mailing Address - Fax:
Practice Address - Street 1:211 E RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5039
Practice Address - Country:US
Practice Address - Phone:319-272-2899
Practice Address - Fax:319-272-2923
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02634225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist