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General NPI Number Information
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NPI Number | 1750758389
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Entity Type | Individual
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Provider Name | LAUREN CARRUTHERS
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Gender | Female
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 8348 TRAFORD LN SUITE 200
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1663
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Country | US
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Telephone | 703-569-7500
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Fax | 703-866-0158
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Provider Business Mailing Address
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Address Line | 3900 FAIRFAX DR APT 1921
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City | ARLINGTON
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State | VA
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Zip | 22203-1661
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Country | US
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Telephone | 703-569-7500
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Fax | 703-866-0158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 2305209772
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License Number State | VA
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