Provider Demographics
NPI:1013567494
Name:HERRITY, LINDSEY RENEE (LPTA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RENEE
Last Name:HERRITY
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9115 EBAUGH LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2666
Mailing Address - Country:US
Mailing Address - Phone:540-742-4719
Mailing Address - Fax:
Practice Address - Street 1:300 TWINRIDGE LN
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5282
Practice Address - Country:US
Practice Address - Phone:804-594-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306604695225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant