Provider Demographics
NPI:1265721252
Name:HEPLER, LAUREN MARY (PTA)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:MARY
Last Name:HEPLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 WILD HORSE CT
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-7577
Mailing Address - Country:US
Mailing Address - Phone:843-455-2415
Mailing Address - Fax:843-903-2742
Practice Address - Street 1:538 WILD HORSE CT
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-7577
Practice Address - Country:US
Practice Address - Phone:843-455-2415
Practice Address - Fax:843-903-2742
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2608225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2608OtherSOUTH CAROLINA BOARD OF PHYSICAL THERAPY EXAMINERS