Provider Demographics
NPI:1134518475
Name:ROY, LAUREN (DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 HUGHES RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8999
Mailing Address - Country:US
Mailing Address - Phone:256-461-9654
Mailing Address - Fax:
Practice Address - Street 1:540 HUGHES RD
Practice Address - Street 2:SUITE 8
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8999
Practice Address - Country:US
Practice Address - Phone:256-461-9654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH7474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51159175OtherBCBS OF AL
AL51159177OtherBCBS OF AL
AL51159177OtherBCBS OF AL