Provider Demographics
NPI:1568421956
Name:LINDLEY, LIESL M (ATC)
Entity Type:Individual
Prefix:
First Name:LIESL
Middle Name:M
Last Name:LINDLEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:NH
Mailing Address - Zip Code:03222-3077
Mailing Address - Country:US
Mailing Address - Phone:603-744-2630
Mailing Address - Fax:603-535-2395
Practice Address - Street 1:17 HIGH ST
Practice Address - Street 2:PLYMOUTH STATE UNIVERSITY, MSC # 22
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1595
Practice Address - Country:US
Practice Address - Phone:603-535-2928
Practice Address - Fax:603-535-2395
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH195174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist