Provider Demographics
NPI:1760146567
Name:STOLLMAN, LAUREN DOMENICA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:DOMENICA
Last Name:STOLLMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 W 94TH TER STE 112
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2534
Mailing Address - Country:US
Mailing Address - Phone:913-224-2990
Mailing Address - Fax:913-224-2992
Practice Address - Street 1:9900 PFLUMM RD STE 66
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-1231
Practice Address - Country:US
Practice Address - Phone:913-224-2990
Practice Address - Fax:913-224-2992
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1106906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist