| Doctor Name: | LAURA ANN-ENNIS CONRAN |
| NPI Number: | 1083867873 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | |
| Business Practice Address: | 5570 Wilson Ave Sw Suite A Grandville, MI - 49418 |
| Business Phone Number: | 6168551495 |
| Business Fax Number: | 6165315027 |
| Mailing Address: | 2120 43rd St Se, Suite 100 GRAND RAPIDS |
| State: | MI |
| Postal Code: | 49508 |
| Phone Number: | 6162811144 |
| Fax Number: | |
| NPI Enumeration Date: | 10/24/2008 |
| NPI Last Update Date: | 05/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |