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NPI Code Detail

MEDICARE: LAUREN DUVALL

MEDICARE: LAUREN DUVALL
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
1225200000XPhysical Therapy Assistant40QB00312800NJ

General Provider Information

NPI Number : 1518355189
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN DUVALL
Provider Business Mailing Address
First Line : 1010 N HANCOCK ST
Second Line : UNIT 212
City : PHILADELPHIA
State : PA
Zip : 19123-2334
Country : US
Telephone Number : 561-809-2834
Fax Number :
Provider Business Practice Location Address
First Line : 1010 N HANCOCK ST
Second Line : UNIT 212
City : PHILADELPHIA
State : PA
Zip : 19123-2334
Country : US
Telephone Number : 561-809-2834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2015
Last Update Date : 01/05/2015

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Directions to “ LAUREN DUVALL ” Practice Location

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