Provider Demographics
NPI:1639895303
Name:DR LAUREN PT LLC
Entity Type:Organization
Organization Name:DR LAUREN PT LLC
Other - Org Name:ACHIEVE MOVEMENT PHYSICAL THERAPY & SPORTS REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-235-2976
Mailing Address - Street 1:9373 FOX TROT LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-4103
Mailing Address - Country:US
Mailing Address - Phone:561-235-2976
Mailing Address - Fax:
Practice Address - Street 1:1200 CLINT MOORE RD STE 11
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2731
Practice Address - Country:US
Practice Address - Phone:561-235-2976
Practice Address - Fax:561-270-5504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy