Provider Demographics
NPI:1003830001
Name:AINSWORTH, LYNNE A (PT)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:A
Last Name:AINSWORTH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:A
Other - Last Name:CORNELIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 GARVINS FALLS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5177
Mailing Address - Country:US
Mailing Address - Phone:603-573-9722
Mailing Address - Fax:
Practice Address - Street 1:22 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4987
Practice Address - Country:US
Practice Address - Phone:603-622-0909
Practice Address - Fax:603-622-2869
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30392180Medicaid
NH101135400OtherACS
NH2872913OtherAETNA
NH386490OtherMVP
NH6107601OtherCIGNA
NH386490OtherMVP