Provider Demographics
NPI:1407621154
Name:MASSOT, LAUREN FAITH (DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:FAITH
Last Name:MASSOT
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11681 VOYAGER PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3864
Mailing Address - Country:US
Mailing Address - Phone:719-344-9342
Mailing Address - Fax:719-375-3531
Practice Address - Street 1:6160 TUTT BLVD STE 240
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3502
Practice Address - Country:US
Practice Address - Phone:719-596-0880
Practice Address - Fax:719-596-0899
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CO19487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist