Provider Demographics
NPI:1104082379
Name:DAVIS, LYNN M (PT)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 SPRING MEADOW CIR
Mailing Address - Street 2:LYNN DAVIS PT, INC
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4955
Mailing Address - Country:US
Mailing Address - Phone:330-519-8431
Mailing Address - Fax:330-799-3976
Practice Address - Street 1:2708 SPRING MEADOW CIR
Practice Address - Street 2:LYNN DAVIS PT, INC
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4955
Practice Address - Country:US
Practice Address - Phone:330-519-8431
Practice Address - Fax:330-799-3976
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 05599261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy