Provider Demographics
NPI:1134763394
Name:GILMAN, LAUREN N (DPT, PT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:N
Last Name:GILMAN
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BENT TREE RD
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-2620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12281 MONETA RD STE B
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-6402
Practice Address - Country:US
Practice Address - Phone:540-296-3203
Practice Address - Fax:434-509-1695
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22132225100000X
VA2305213269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist