Provider Demographics
NPI:1851514186
Name:WEDLOW, LAUREN LEJUNE (PT)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:LEJUNE
Last Name:WEDLOW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9449 IMPERIAL HWY
Mailing Address - Street 2:PM & R GARDEN - 4TH FLR
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2814
Mailing Address - Country:US
Mailing Address - Phone:562-657-2427
Mailing Address - Fax:562-657-2928
Practice Address - Street 1:9449 IMPERIAL HWY
Practice Address - Street 2:PM & R GARDEN 4TH FLR
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2814
Practice Address - Country:US
Practice Address - Phone:562-657-2427
Practice Address - Fax:562-657-2928
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 10328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist