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General NPI Number Information
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NPI Number | 1053567057
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Entity Type | Organization
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Legal Business Name | LYNN DAVIS PT, INC.
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 2708 SPRING MEADOW CIR
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-4955
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Country | US
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Telephone | 330-519-8431
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Fax | 330-799-3976
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Provider Business Mailing Address
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Address Line | 2708 SPRING MEADOW CIR
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-4955
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Country | US
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Telephone | 330-519-8431
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Fax | 330-799-3976
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, OWNER
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Name | LYNN DAVIS
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Credential | P.T.
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Telephone | 330-519-8431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA 03719
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-07469
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 006691
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT - 05599
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License Number State | OH
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