Provider Demographics
NPI:1568026763
Name:CLAPP, LINDSEY JO (PTA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JO
Last Name:CLAPP
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:JO
Other - Last Name:SHORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6312 S 196TH DR
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-4824
Mailing Address - Country:US
Mailing Address - Phone:602-828-0942
Mailing Address - Fax:
Practice Address - Street 1:6312 S 196TH DR
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-4824
Practice Address - Country:US
Practice Address - Phone:602-828-0942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPTA-013841208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation