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NPI Code Detail

MEDICARE: MISS LINDSAY MICHELLE DEERE PHYSICAL THERAPIST P

MEDICARE: MISS LINDSAY MICHELLE DEERE PHYSICAL THERAPIST P
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1999137985MO

General Provider Information

NPI Number : 1649340662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LINDSAY MICHELLE DEERE PHYSICAL THERAPIST P
Provider Business Mailing Address
First Line : 1230 JOHNSON FERRY PL STE G10
Second Line :
City : MARIETTA
State : GA
Zip : 30068-2045
Country : US
Telephone Number : 770-321-6705
Fax Number : 404-591-3891
Provider Business Practice Location Address
First Line : 1230 JOHNSON FERRY PL STE G10
Second Line :
City : MARIETTA
State : GA
Zip : 30068-2045
Country : US
Telephone Number : 770-321-6705
Fax Number : 404-551-8891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 03/04/2022

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