Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT35920 | FL |
NPI | 1053920470 |
---|---|
Provider Name | Lindsay Ann Landry |
First Address | Temple Terrace, FL 33637-0925 |
Second Address | Temple Terrace, FL 33637-0925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2020 |
Last Update Date | 31/07/2020 |