MEDICARE: LINDSEY LEQUIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT015897	GA

General Provider Information

NPI Number	:	1518606524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY LEQUIER

Provider Business Mailing Address
First Line	:	500 LANIER AVE W STE 303
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-7636
Country	:	US
Telephone Number	:	770-716-8885
Fax Number	:	770-716-7425

Provider Business Practice Location Address
First Line	:	965 PIEDMONT RD NE STE 200
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-5493
Country	:	US
Telephone Number	:	770-575-2212
Fax Number	:	770-575-2547

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	05/31/2022

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Directions to “ LINDSEY LEQUIER ” Practice Location

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