Provider Demographics
NPI:1841620275
Name:LINDSAY, LORI (PT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:LINDSAY
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:PO BOX 1975
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-1975
Mailing Address - Country:US
Mailing Address - Phone:706-236-2755
Mailing Address - Fax:866-647-2045
Practice Address - Street 1:50 TOWN CT
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2589
Practice Address - Country:US
Practice Address - Phone:386-313-5974
Practice Address - Fax:866-647-2045
Is Sole Proprietor?:No
Enumeration Date:2013-11-21
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHT857ZMedicare PIN
FLHYT857YMedicare PIN