Provider Demographics
NPI:1104118009
Name:GOCKLEY, LAUREN SANDRA (ATC)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:SANDRA
Last Name:GOCKLEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-3285
Mailing Address - Country:US
Mailing Address - Phone:610-921-1252
Mailing Address - Fax:
Practice Address - Street 1:1018 VICTORIA DR
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-3285
Practice Address - Country:US
Practice Address - Phone:610-921-1252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer