Provider Demographics
NPI:1013931005
Name:MATTINGLY, LAUREN K (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:K
Last Name:MATTINGLY
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:4020 TAYLORSVILLE RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1569
Mailing Address - Country:US
Mailing Address - Phone:502-479-2552
Mailing Address - Fax:502-479-2539
Practice Address - Street 1:4020 TAYLORSVILLE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1569
Practice Address - Country:US
Practice Address - Phone:502-479-2552
Practice Address - Fax:502-479-2539
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY003595225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist