Provider Demographics
NPI:1821229303
Name:RAY, LAUREN LEIGH (DPT, ATC, NASM-PES)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LEIGH
Last Name:RAY
Suffix:
Gender:F
Credentials:DPT, ATC, NASM-PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2269 WILMA RUDOLPH BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-3179
Mailing Address - Country:US
Mailing Address - Phone:931-905-1729
Mailing Address - Fax:
Practice Address - Street 1:2269 WILMA RUDOLPH BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-3179
Practice Address - Country:US
Practice Address - Phone:931-905-1729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-02
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN84152251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic