Provider Demographics
NPI:1912795253
Name:LLOYD, ANITRA R (LMT)
Entity type:Individual
Prefix:
First Name:ANITRA
Middle Name:R
Last Name:LLOYD
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 CLYDE PL SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710-2127
Mailing Address - Country:US
Mailing Address - Phone:724-786-8048
Mailing Address - Fax:
Practice Address - Street 1:2424 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1514
Practice Address - Country:US
Practice Address - Phone:330-478-2255
Practice Address - Fax:330-478-0505
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33026249225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist