Healthcare Provider Details

I. General information

NPI: 1851759740
Provider Name (Legal Business Name): LINDSEY MCGLINCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OLD HARSHMAN RD
RIVERSIDE OH
45431-1238
US

IV. Provider business mailing address

801 OLD HARSHMAN RD
RIVERSIDE OH
45431-1238
US

V. Phone/Fax

Practice location:
  • Phone: 937-825-6412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number388222
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: