Individual
LAUREN COLLIER PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7415 N MAY AVE, OKLAHOMA CITY, OK 73116
(405) 400-8909
(405) 400-8949
Mailing address
1808 MULHOLLAND DR, EDMOND, OK 73012-4120
(405) 230-6330
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
076040
IA
225100000X
Physical Therapist
3254
NE
225100000X
Physical Therapist
Primary
5393
OK
2251X0800X
Orthopedic Physical Therapist
3254
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09856254001
—
NE
Enumeration date
07/31/2013
Last updated
06/14/2018
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