Provider Demographics
NPI:1245429646
Name:LLOYD, CONNIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:
Last Name:LLOYD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:GREENBANK
Mailing Address - State:WA
Mailing Address - Zip Code:98253-9731
Mailing Address - Country:US
Mailing Address - Phone:360-222-3445
Mailing Address - Fax:
Practice Address - Street 1:756 PLANTATION DR
Practice Address - Street 2:
Practice Address - City:GREENBANK
Practice Address - State:WA
Practice Address - Zip Code:98253-9731
Practice Address - Country:US
Practice Address - Phone:360-222-3445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00000700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist