Provider Demographics
NPI:1093014623
Name:ABERCROMBIE, LINDSEY KAY (PTA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:KAY
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 1/2 HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-4362
Mailing Address - Country:US
Mailing Address - Phone:229-938-4081
Mailing Address - Fax:229-924-9540
Practice Address - Street 1:205 E LAMAR ST
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3632
Practice Address - Country:US
Practice Address - Phone:229-924-9595
Practice Address - Fax:229-924-9540
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA002760225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant