Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2306604695 | VA |
NPI | 1013567494 |
---|---|
Provider Name | Lindsey Renee Herrity |
First Address | Mechanicsville, VA 23116-2666 |
Second Address | North Chesterfield, VA 23235-5282 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2019 |
Last Update Date | 17/09/2019 |