Provider Demographics
NPI:1407198062
Name:SIDES, LAUREN PARKER (MPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:PARKER
Last Name:SIDES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:68 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2722
Mailing Address - Country:US
Mailing Address - Phone:828-586-7235
Mailing Address - Fax:828-586-7227
Practice Address - Street 1:68 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-2722
Practice Address - Country:US
Practice Address - Phone:828-586-7235
Practice Address - Fax:828-586-7227
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPT133992251X0800X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic