Provider Demographics
NPI:1588035455
Name:MCGINN, LAUREN E (PTA)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:E
Last Name:MCGINN
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 1:400 TRADECENTER
Mailing Address - Street 2:SUITE 4890
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-7452
Mailing Address - Country:US
Mailing Address - Phone:727-744-1651
Mailing Address - Fax:
Practice Address - Street 1:400 TRADECENTER
Practice Address - Street 2:SUITE 4890
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-7452
Practice Address - Country:US
Practice Address - Phone:727-744-1651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9031225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant