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Individual

DR. LAURA MANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT, OCS

Contact information

Practice address
1315 NW 4TH ST, SUITE B, REDMOND, OR 97756-1328
(541) 504-2350
(541) 504-2354
Mailing address
805 SW INDUSTRIAL WAY, SUITE 3, BEND, OR 97702-1093
(541) 585-2529
(541) 585-2536

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60522
OR
225100000X
Physical Therapist
7755
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500670063
OR
Enumeration date
07/30/2007
Last updated
12/08/2015
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