Provider Demographics
NPI:1326595927
Name:COST, LAUREN (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:COST
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11909 HOOD LANDING RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-2028
Mailing Address - Country:US
Mailing Address - Phone:904-716-1098
Mailing Address - Fax:904-494-8743
Practice Address - Street 1:14866 OLD ST. AUGUSTINE ROAD
Practice Address - Street 2:SUITE 113
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258
Practice Address - Country:US
Practice Address - Phone:904-348-0039
Practice Address - Fax:904-494-8743
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11821111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor