Provider Demographics
NPI:1649946930
Name:LUZAR, LAUREN RILEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RILEY
Last Name:LUZAR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 ELKHORN RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2786
Mailing Address - Country:US
Mailing Address - Phone:270-303-0204
Mailing Address - Fax:
Practice Address - Street 1:2344 ELKHORN RD STE 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2786
Practice Address - Country:US
Practice Address - Phone:270-303-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist