Provider Demographics
NPI:1447536164
Name:ALLEN, LAUREN ENGSTROM (PT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ENGSTROM
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:A
Other - Last Name:ENGSTROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-535-8758
Mailing Address - Fax:919-535-3271
Practice Address - Street 1:103 PARKWAY OFFICE CT STE 102
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7429
Practice Address - Country:US
Practice Address - Phone:919-615-3527
Practice Address - Fax:919-977-5725
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0397730070Medicare NSC