Healthcare Provider Details

I. General information

NPI: 1992288583
Provider Name (Legal Business Name): CRAIG DONALD LINDSEY AT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 MONTGOMERY RD
CINCINNATI OH
45242-7711
US

IV. Provider business mailing address

500 E BUSINESS WAY
CINCINNATI OH
45241-2374
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-1680
  • Fax:
Mailing address:
  • Phone: 513-389-3666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number000930
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: