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NPI Code Detail

MEDICARE: DR. LAUREN ALEXANDRA FANNING DPT

MEDICARE: DR. LAUREN ALEXANDRA FANNING 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 TherapistP22615NC

General Provider Information

NPI Number : 1699559401
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAUREN ALEXANDRA FANNING DPT
Provider Business Mailing Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 762-408-2273
Fax Number :
Provider Business Practice Location Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 762-408-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2023
Last Update Date : 12/10/2025

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