Provider Demographics
NPI:1689975716
Name:LUKE, LAUREN (PT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LUKE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:656 MAGNOLIA WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-6052
Mailing Address - Country:US
Mailing Address - Phone:225-800-2570
Mailing Address - Fax:225-522-2119
Practice Address - Street 1:6160 PERKINS RD STE 134
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4191
Practice Address - Country:US
Practice Address - Phone:225-800-2570
Practice Address - Fax:225-522-2119
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1669062329OtherNPI 2