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NPI 1720833155

NPI 1720833155 : LYNDSEY DARDEN : ATHENS, GA

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General NPI Number Information
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    NPI Number           |    1720833155
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    Entity Type          |    Individual 
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    Provider Name        |    LYNDSEY DARDEN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/19/2024
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    Last Update Date     |    04/24/2024
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Provider Practice Location Address
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    Address Line         |    330 RIVER ROAD RAMSEY 367 
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    City                 |    ATHENS
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    State                |    GA
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    Zip                  |    30602-0001
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    Country              |    US
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    Telephone            |    706-542-4427
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    400 BRIDGEGATE WAY 
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    City                 |    MCDONOUGH
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    State                |    GA
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    Zip                  |    30252-4066
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    Country              |    US
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    Telephone            |    
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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        |    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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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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