Healthcare Provider Details

I. General information

NPI: 1013478866
Provider Name (Legal Business Name): LAUREN WEBER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 ROUTE 113 # 6
SOUDERTON PA
18964-1000
US

IV. Provider business mailing address

723 ROUTE 113 # 6
SOUDERTON PA
18964-1000
US

V. Phone/Fax

Practice location:
  • Phone: 215-538-1999
  • Fax: 267-382-0088
Mailing address:
  • Phone: 215-538-1999
  • Fax: 267-382-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT027536
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: