Provider Demographics
NPI:1194905943
Name:LINDSEY, MARY ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANN
Last Name:LINDSEY
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 1:26336 E HURON RIVER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLAT ROCK
Mailing Address - State:MI
Mailing Address - Zip Code:48134-1833
Mailing Address - Country:US
Mailing Address - Phone:734-789-8281
Mailing Address - Fax:734-789-8258
Practice Address - Street 1:1779 N. DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162
Practice Address - Country:US
Practice Address - Phone:734-289-1800
Practice Address - Fax:734-289-1801
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist