Provider Demographics
NPI:1013096726
Name:LARKEY, LAUREN MASSEY (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:MASSEY
Last Name:LARKEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:LEANE
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:1111 BULLSBORO DR
Practice Address - Street 2:SUITE 3
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2182
Practice Address - Country:US
Practice Address - Phone:770-251-7284
Practice Address - Fax:770-251-7295
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008415225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPT008415OtherSTATE LISC NUMBER