Provider Demographics
NPI:1447969886
Name:PALMER, LAURA SUE (PT, DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:SUE
Last Name:PALMER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:SUE
Other - Last Name:JUDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1200 VALLEY WEST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1904
Mailing Address - Country:US
Mailing Address - Phone:515-440-3439
Mailing Address - Fax:515-440-3832
Practice Address - Street 1:1200 VALLEY WEST DR STE 300
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1904
Practice Address - Country:US
Practice Address - Phone:515-440-3439
Practice Address - Fax:515-440-3832
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111824225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist