Provider Demographics
NPI:1437885712
Name:LINDSEY, JOHN THOMAS JR
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:LINDSEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 GLENN VALLEY LN APT 205
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-0226
Mailing Address - Country:US
Mailing Address - Phone:704-294-8331
Mailing Address - Fax:
Practice Address - Street 1:1042 GLENN VALLEY LN APT 205
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-0226
Practice Address - Country:US
Practice Address - Phone:704-294-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19453225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist