Provider Demographics
NPI:1538532486
Name:SPITSBERG, LAUREN PAIGE (DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:PAIGE
Last Name:SPITSBERG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:PAIGE
Other - Last Name:BUCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:171 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2547
Mailing Address - Country:US
Mailing Address - Phone:603-228-7500
Mailing Address - Fax:
Practice Address - Street 1:171 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2547
Practice Address - Country:US
Practice Address - Phone:603-228-7500
Practice Address - Fax:603-228-3503
Is Sole Proprietor?:No
Enumeration Date:2015-11-01
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist