Provider Demographics
NPI:1225346679
Name:SHAUB, LAUREN E (DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:SHAUB
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 1:4623 31ST RD S
Mailing Address - Street 2:B1
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1618
Mailing Address - Country:US
Mailing Address - Phone:610-413-2475
Mailing Address - Fax:
Practice Address - Street 1:2445 ARMY NAVY DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2905
Practice Address - Country:US
Practice Address - Phone:703-769-8442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT19966225100000X
VA23052061432251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist