Provider Demographics
NPI:1104076520
Name:LINTHICUM, SUMMER MICHELLE (DPT)
Entity type:Individual
Prefix:DR
First Name:SUMMER
Middle Name:MICHELLE
Last Name:LINTHICUM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5072 W PLANO PKWY
Mailing Address - Street 2:100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4476
Mailing Address - Country:US
Mailing Address - Phone:972-818-3888
Mailing Address - Fax:972-818-3889
Practice Address - Street 1:5072 W PLANO PKWY
Practice Address - Street 2:100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4476
Practice Address - Country:US
Practice Address - Phone:972-818-3888
Practice Address - Fax:972-818-3889
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1179533OtherSTATE LICENSE