Provider Demographics
NPI:1699321414
Name:WOMACK, LINDSAY DEANNA (LAT, ATC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:DEANNA
Last Name:WOMACK
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 AVENUE 8 SE
Mailing Address - Street 2:
Mailing Address - City:ATKINS
Mailing Address - State:AR
Mailing Address - Zip Code:72823-4924
Mailing Address - Country:US
Mailing Address - Phone:501-697-7336
Mailing Address - Fax:
Practice Address - Street 1:100 WALMART DR
Practice Address - Street 2:
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110-4522
Practice Address - Country:US
Practice Address - Phone:501-477-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer