Provider Demographics
NPI:1922330117
Name:GASKILL, LAUREN COLLEEN (MSPT)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:COLLEEN
Last Name:GASKILL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 S COLLEGE ST
Mailing Address - Street 2:APT 2108
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4368
Mailing Address - Country:US
Mailing Address - Phone:856-430-0297
Mailing Address - Fax:
Practice Address - Street 1:1209 S COLLEGE ST
Practice Address - Street 2:APT 2108
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-4368
Practice Address - Country:US
Practice Address - Phone:856-430-0297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12289174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist