Provider Demographics
NPI:1215454285
Name:COURETON, LAUREN R (DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:R
Last Name:COURETON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:R
Other - Last Name:DOUGLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4273 KEATON CROSSING BLVD
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8220
Mailing Address - Country:US
Mailing Address - Phone:636-206-4225
Mailing Address - Fax:636-422-1051
Practice Address - Street 1:1155 HAZEL LN
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1920
Practice Address - Country:US
Practice Address - Phone:573-756-2937
Practice Address - Fax:573-756-2939
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist