Individual
LAUREN BOLLACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742-6710
(301) 790-8000
Mailing address
1635 NEEDY RD, MARTINSBURG, WV 25405-6200
(540) 877-5003
(855) 232-8604
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605182
VA
225200000X
Physical Therapy Assistant
A5025
MD
Other
Enumeration date
12/27/2018
Last updated
04/07/2021
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