Basic Information
Provider Information
NPI: 1134467350
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROMIG
FirstName: LAURA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5010 S BOSTON ST
Address2:  
City: GREENWOOD VILLAGE
State: CO
PostalCode: 801111318
CountryCode: US
TelephoneNumber: 3039475009
FaxNumber:  
Practice Location
Address1: 27240 HAGGERTY RD
Address2: STE. E-15
City: FARMINGTON HILLS
State: MI
PostalCode: 483315716
CountryCode: US
TelephoneNumber: 8669910900
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/23/2013
LastUpdateDate: 01/23/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X0009747COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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