Provider Demographics
NPI:1548769995
Name:MCGRAW, LAUREN LOUISE (AT, ATC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LOUISE
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:AT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 APPLE ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-1448
Mailing Address - Country:US
Mailing Address - Phone:440-781-8674
Mailing Address - Fax:
Practice Address - Street 1:310 E MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2434
Practice Address - Country:US
Practice Address - Phone:419-448-2290
Practice Address - Fax:419-448-2007
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0054582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer