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NPI Code Detail

MEDICARE: LAUREN MILLER CONWAY DPT

MEDICARE: LAUREN MILLER CONWAY DPT
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
1225100000XPhysical Therapist10007SC

General Provider Information

NPI Number : 1417414590
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN MILLER CONWAY DPT
Provider Business Mailing Address
First Line : 1377 MOTOR PKWY STE 307
Second Line :
City : ISLANDIA
State : NY
Zip : 11749-5258
Country : US
Telephone Number : 757-932-4261
Fax Number : 631-580-5200
Provider Business Practice Location Address
First Line : 439 CHANNEL RD STE 102
Second Line :
City : LAKE WYLIE
State : SC
Zip : 29710-6101
Country : US
Telephone Number : 803-746-7800
Fax Number : 803-670-3068
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2019
Last Update Date : 12/03/2025

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Directions to “ LAUREN MILLER CONWAY DPT” Practice Location

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