Individual
LAURA JEAN GORESLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2210 MAIN ST, LONGMONT, CO 80501-1456
(303) 651-7022
Mailing address
4692 GORDON DR, BOULDER, CO 80305-6735
(303) 494-6544
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2989
CO
Other
Enumeration date
01/17/2010
Last updated
01/17/2010
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