Provider Demographics
NPI:1467769042
Name:GITTUS, LAUREN N (DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:N
Last Name:GITTUS
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:PO BOX 681478
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1478
Mailing Address - Country:US
Mailing Address - Phone:615-591-6590
Mailing Address - Fax:615-591-6601
Practice Address - Street 1:100 BLUEGRASS COMMONS
Practice Address - Street 2:SUITE 120
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2725
Practice Address - Country:US
Practice Address - Phone:615-822-8804
Practice Address - Fax:615-822-8577
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4274567OtherBCBS OF TN
TN4274567OtherBCBS OF TN