Provider Demographics
NPI:1720128416
Name:MCKEVER, LINDSAY ANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:ANNE
Last Name:MCKEVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LINDSAY
Other - Middle Name:ANNE
Other - Last Name:SCRIBNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:800 N FANT ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5708
Mailing Address - Country:US
Mailing Address - Phone:864-512-1417
Mailing Address - Fax:864-512-1823
Practice Address - Street 1:800 N FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5708
Practice Address - Country:US
Practice Address - Phone:864-512-1198
Practice Address - Fax:864-512-3608
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PT-0011681225100000X
SCPT.5624225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1882Medicaid