Healthcare Provider Details

I. General information

NPI: 1386314128
Provider Name (Legal Business Name): LINDSEY M GREER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7202 SHAVANO AVE
FREDERICK CO
80504-5887
US

IV. Provider business mailing address

7202 SHAVANO AVE
FREDERICK CO
80504-5887
US

V. Phone/Fax

Practice location:
  • Phone: 303-718-0678
  • Fax:
Mailing address:
  • Phone: 303-718-0678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0012297
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: