Provider Demographics
NPI:1598578874
Name:BIDDINGER, LUCILLE N (PTA)
Entity type:Individual
Prefix:
First Name:LUCILLE
Middle Name:N
Last Name:BIDDINGER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 LEE ANN DR
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-1506
Mailing Address - Country:US
Mailing Address - Phone:419-308-3454
Mailing Address - Fax:
Practice Address - Street 1:14442 US HIGHWAY 33 # 14357
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:OH
Practice Address - Zip Code:43331-9284
Practice Address - Country:US
Practice Address - Phone:937-843-4929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH003763225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant