Provider Demographics
NPI:1568171361
Name:MCILWAIN, LINDSEY M
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:M
Last Name:MCILWAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 THISTLEDOWN DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2052
Mailing Address - Country:US
Mailing Address - Phone:334-419-8462
Mailing Address - Fax:
Practice Address - Street 1:1433 THISTLEDOWN DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-2052
Practice Address - Country:US
Practice Address - Phone:334-419-8462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer