Provider Demographics
NPI:1992564595
Name:HARVILLE, LINDSEY (ATC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:HARVILLE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:SHARPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:493 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-6316
Mailing Address - Country:US
Mailing Address - Phone:762-207-3122
Mailing Address - Fax:
Practice Address - Street 1:497 AZALEA DR STE 102
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-7906
Practice Address - Country:US
Practice Address - Phone:762-207-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAT-07982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer