Provider Demographics
NPI:1992424170
Name:POWELL, LAUREN R (PT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:R
Last Name:POWELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 911063
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-1063
Mailing Address - Country:US
Mailing Address - Phone:859-797-5513
Mailing Address - Fax:859-898-0538
Practice Address - Street 1:880 CORPORATE DR STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-5449
Practice Address - Country:US
Practice Address - Phone:859-797-5513
Practice Address - Fax:859-898-0538
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14368225100000X
KYPT-008904225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist