Healthcare Provider Details

I. General information

NPI: 1881786937
Provider Name (Legal Business Name): LYNN M HEMMELGARN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 N MAIN ST
MINSTER OH
45865-9500
US

IV. Provider business mailing address

933 STATE ROUTE 716
MARIA STEIN OH
45860-9787
US

V. Phone/Fax

Practice location:
  • Phone: 419-628-6920
  • Fax: 419-628-8028
Mailing address:
  • Phone: 419-447-7203
  • Fax: 419-447-5577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05418
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: