Provider Demographics
NPI:1568692325
Name:SMITH, LINDSAY (PT)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 NAT TURNER BLVD S
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2899
Mailing Address - Country:US
Mailing Address - Phone:757-594-0330
Mailing Address - Fax:757-594-0332
Practice Address - Street 1:204 NAT TURNER BLVD S
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2899
Practice Address - Country:US
Practice Address - Phone:757-594-0330
Practice Address - Fax:757-594-0332
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist