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General NPI Number Information
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NPI Number | 1013942267
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Entity Type | Individual
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Provider Name | LINDSEY MARJORIE CREELY PT, DPT, ATC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 103 W MICHIGAN AVE
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City | CLINTON
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State | MI
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Zip | 49236-9577
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Country | US
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Telephone | 517-456-5080
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Fax |
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Provider Business Mailing Address
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Address Line | 3145 W CLARK RD SUITE 106
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City | YPSILANTI
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State | MI
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Zip | 48197-1120
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Country | US
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Telephone | 734-528-9760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501015173
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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