Provider Demographics
NPI:1700045739
Name:MANUEL, LAUREN JON (LMT)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:JON
Last Name:MANUEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 FOREST HILL BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6058
Mailing Address - Country:US
Mailing Address - Phone:561-966-8800
Mailing Address - Fax:561-439-2300
Practice Address - Street 1:1825 FOREST HILL BLVD STE 104
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6058
Practice Address - Country:US
Practice Address - Phone:561-966-8800
Practice Address - Fax:561-439-2300
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA3453225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist