Provider Demographics
NPI:1760938401
Name:SCHAEFER, LAUREN NOELE (DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:NOELE
Last Name:SCHAEFER
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 1:615 S HUGHES BOULEVARD
Mailing Address - Street 2:UNIT B
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909
Mailing Address - Country:US
Mailing Address - Phone:252-335-2087
Mailing Address - Fax:252-335-2682
Practice Address - Street 1:615 S HUGHES BOULEVARD
Practice Address - Street 2:UNIT B
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909
Practice Address - Country:US
Practice Address - Phone:252-335-2087
Practice Address - Fax:252-335-2682
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16513225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist