Provider Demographics
NPI:1578931853
Name:STUBBS, LAUREN ALEXIS (DPT)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ALEXIS
Last Name:STUBBS
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 1:1547 BYPASS RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-2714
Mailing Address - Country:US
Mailing Address - Phone:859-744-4411
Mailing Address - Fax:
Practice Address - Street 1:1547 BYPASS RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-2714
Practice Address - Country:US
Practice Address - Phone:859-744-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006682225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist