Provider Demographics
NPI:1245209758
Name:LOUGHRAN, LINDSEY M (MED, ATC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:M
Last Name:LOUGHRAN
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-6051
Mailing Address - Country:US
Mailing Address - Phone:602-764-8155
Mailing Address - Fax:
Practice Address - Street 1:1900 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-6051
Practice Address - Country:US
Practice Address - Phone:602-884-4851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL960021242255A2300X
AZ13342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer