Provider Demographics
NPI:1467792820
Name:FEARY, LINDSAY (PTA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:FEARY
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 1:608 E COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:BATESBURG-LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-7318
Mailing Address - Country:US
Mailing Address - Phone:803-532-0051
Mailing Address - Fax:803-532-9685
Practice Address - Street 1:608 E COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:BATESBURG-LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-7318
Practice Address - Country:US
Practice Address - Phone:803-532-0051
Practice Address - Fax:803-532-9685
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist