MEDICARE: LAUREN ROSE CLARK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P24739	NC

General Provider Information

NPI Number	:	1295687432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ROSE CLARK

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-702-4389
Fax Number	:

Provider Business Practice Location Address
First Line	:	868 TIMBER DR
Second Line	:
City	:	GARNER
State	:	NC
Zip	:	27529-4850
Country	:	US
Telephone Number	:	984-789-3390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ LAUREN ROSE CLARK ” Practice Location

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