Provider Demographics
NPI:1326572140
Name:SERR, LUCINDA (PT)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:
Last Name:SERR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LUCINDA
Other - Middle Name:
Other - Last Name:EYINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:14601 BOTKINS RD
Mailing Address - Street 2:
Mailing Address - City:BOTKINS
Mailing Address - State:OH
Mailing Address - Zip Code:45306-9793
Mailing Address - Country:US
Mailing Address - Phone:937-693-7322
Mailing Address - Fax:
Practice Address - Street 1:33533 W 12 MILE RD STE 290
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-5635
Practice Address - Country:US
Practice Address - Phone:855-925-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT9126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist