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General NPI Number Information
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NPI Number | 1770982381
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Entity Type | Individual
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Provider Name | LYDIA MARIE HANDON PTA
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Gender | Female
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 3701 OLSEN BLVD
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City | AMARILLO
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State | TX
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Zip | 79109-3053
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Country | US
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Telephone | 806-467-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 S JACKSON ST
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City | AMARILLO
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State | TX
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Zip | 79109-2317
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Country | US
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Telephone | 806-282-4687
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2097241
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License Number State | TX
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