Provider Demographics
NPI:1437806585
Name:POLING-DAY, LYNN ANN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ANN
Last Name:POLING-DAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 NW TREASURE COAST DR APT 201
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4412
Mailing Address - Country:US
Mailing Address - Phone:772-349-6270
Mailing Address - Fax:
Practice Address - Street 1:3600 NW TREASURE COAST DR APT 201
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4412
Practice Address - Country:US
Practice Address - Phone:772-349-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA73052225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist