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General NPI Number Information
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NPI Number | 1790466019
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Entity Type | Individual
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Provider Name | LAUREN CLAIRE STANLEY MS, ACSM EP-C
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Gender | Female
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Dates
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Enumeration Date | 07/28/2023
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 106 S OLD KILBOURNE RD STE B
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City | OAK GROVE
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State | LA
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Zip | 71263-8900
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Country | US
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Telephone | 318-299-7607
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Fax |
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Provider Business Mailing Address
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Address Line | 106 S OLD KILBOURNE RD STE B
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City | OAK GROVE
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State | LA
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Zip | 71263-8900
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Country | US
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Telephone | 318-547-9239
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Fax |
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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 | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number | 852332
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License Number State | LA
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