Provider Demographics
NPI:1851197552
Name:WHITE, LAUREN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:WHITE
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 STARBIRD RD
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-2525
Mailing Address - Country:US
Mailing Address - Phone:802-338-6994
Mailing Address - Fax:
Practice Address - Street 1:1191 S BROWNELL RD STE 10
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-7415
Practice Address - Country:US
Practice Address - Phone:315-491-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0134909225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist