Provider Demographics
NPI:1124116595
Name:TUCKER, LAUREN SCHOFIELD (DC)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:SCHOFIELD
Last Name:TUCKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105A WESTTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4941
Mailing Address - Country:US
Mailing Address - Phone:610-696-8888
Mailing Address - Fax:610-696-8282
Practice Address - Street 1:105A WESTTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4941
Practice Address - Country:US
Practice Address - Phone:610-696-8888
Practice Address - Fax:610-696-8282
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006145PA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALA21034430000OtherBLUE CROSS (IBC)
PAU73834Medicare UPIN
PA023759Medicare ID - Type Unspecified