Provider Demographics
NPI:1730200353
Name:CULPEPPER, LAUREN MIRANDA (ATC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:MIRANDA
Last Name:CULPEPPER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 COUNTY ROAD 15
Mailing Address - Street 2:
Mailing Address - City:UNION SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:36089-4381
Mailing Address - Country:US
Mailing Address - Phone:334-868-4311
Mailing Address - Fax:
Practice Address - Street 1:1125 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2313
Practice Address - Country:US
Practice Address - Phone:334-284-8490
Practice Address - Fax:334-288-0843
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer