Provider Demographics
NPI:1275771081
Name:DEGORY, LAUREN SCHNEIDER (DPT)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:SCHNEIDER
Last Name:DEGORY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4824 MCMAHON BLVD NW
Mailing Address - Street 2:STE 101
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5412
Mailing Address - Country:US
Mailing Address - Phone:505-897-3575
Mailing Address - Fax:505-897-3726
Practice Address - Street 1:4824 MCMAHON BLVD NW
Practice Address - Street 2:STE 101
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5412
Practice Address - Country:US
Practice Address - Phone:505-897-3575
Practice Address - Fax:505-897-3726
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist