Individual
LAURA M PROUTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4700
(920) 430-4747
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12018
WI
Other
Enumeration date
06/12/2012
Last updated
07/19/2023
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