Provider Demographics
NPI:1992374664
Name:MAY, LAUREN JILL (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:JILL
Last Name:MAY
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:JILL
Other - Last Name:TEMPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPTA
Mailing Address - Street 1:500 BARRETT DR
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MO
Mailing Address - Zip Code:63863-1204
Mailing Address - Country:US
Mailing Address - Phone:573-421-4273
Mailing Address - Fax:
Practice Address - Street 1:500 BARRETT DR
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MO
Practice Address - Zip Code:63863-1204
Practice Address - Country:US
Practice Address - Phone:573-421-4273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014038455225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant