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General NPI Number Information
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NPI Number | 1346295714
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Entity Type | Individual
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Provider Name | JEFFREY DAVID LYMAN MSPT
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 44 LETENDRE AVE
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City | FEEDING HILLS
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State | MA
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Zip | 01030-1908
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Country | US
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Telephone | 860-763-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 36 WOODLAND STREET
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City | HARTFORD
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State | CT
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Zip | 06105-2325
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Country | US
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Telephone | 860-522-2717
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Fax | 860-240-7605
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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 | 007813
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License Number State | CT
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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 | 17390
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License Number State | MA
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