Provider Demographics
NPI:1538460829
Name:GRAPPONE, LAUREN REDDY (PTA)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:REDDY
Last Name:GRAPPONE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79393 RIDGEHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-6430
Mailing Address - Country:US
Mailing Address - Phone:980-833-0266
Mailing Address - Fax:
Practice Address - Street 1:6000 PARK SOUTH DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3298
Practice Address - Country:US
Practice Address - Phone:704-551-6800
Practice Address - Fax:704-551-6868
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3312225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant