Provider Demographics
NPI:1871976621
Name:FRICK, LAUREN NICOLE (LAT, ATC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:FRICK
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WORTHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07832-2653
Mailing Address - Country:US
Mailing Address - Phone:908-507-6983
Mailing Address - Fax:
Practice Address - Street 1:5 WORTHINGTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:NJ
Practice Address - Zip Code:07832-2653
Practice Address - Country:US
Practice Address - Phone:908-507-6983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer