Provider Demographics
NPI:1326124025
Name:LANSING, JUDITH (PTA)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:LANSING
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 1:851 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-1816
Mailing Address - Country:US
Mailing Address - Phone:508-336-7912
Mailing Address - Fax:
Practice Address - Street 1:100 SMITHFIELD AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3497
Practice Address - Country:US
Practice Address - Phone:401-725-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00034225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant