Provider Demographics
NPI:1235527425
Name:SIERS, LAUREN ELISE (DPT, ATC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISE
Last Name:SIERS
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ELISE
Other - Last Name:BENEDUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, ATC
Mailing Address - Street 1:249 W. 2ND ST.
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452
Mailing Address - Country:US
Mailing Address - Phone:304-269-8097
Mailing Address - Fax:304-269-8187
Practice Address - Street 1:249 W. 2ND ST.
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452
Practice Address - Country:US
Practice Address - Phone:304-269-8097
Practice Address - Fax:304-269-8187
Is Sole Proprietor?:No
Enumeration Date:2014-12-23
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV003310225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist