Provider Demographics
NPI:1891103933
Name:POBIAK, LAUREN (DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:POBIAK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:HERTZLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:16412 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23834-5453
Mailing Address - Country:US
Mailing Address - Phone:804-520-7779
Mailing Address - Fax:866-719-9734
Practice Address - Street 1:16412 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:SOUTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23834-5453
Practice Address - Country:US
Practice Address - Phone:804-520-7779
Practice Address - Fax:866-719-9734
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208890225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist