Lauren Blake, PTA
Individual provider Active NPI Physical Therapy Assistant · Morgantown, WV
NPI 1386921906 · NPPES record last updated Jun 19, 2013
Key facts
- NPI
- 1386921906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 3990 (WV)
- Practice address
- 161 Bakers Ridge Rd
Morgantown, WV 26508-1459 - Phone
- (304) 285-0692
- NPI assigned
- Nov 10, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3990 | WV | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3990 | WV | Yes |
Addresses
Primary practice location
161 Bakers Ridge Rd
Morgantown, WV 26508-1459
Mailing address
1300 Peacock LN
Fairmont, WV 26554-2420
Other providers in Morgantown, WV
- Megan Blahut
- Abigail Blake
- Elizabeth Grace Blake
- Harlee Jean Blake
- Jean Blake
- Morgan Bland
- Matthew Blaney
- Stephanie Joann Blaney
- Josh Blankenship
- Kevin J Blankenship
All providers in Morgantown, WV · Physical Therapy Assistant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.