Provider Demographics
NPI:1598117319
Name:FAUSETT, LINDSAY MICHELLE (LAT)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:MICHELLE
Last Name:FAUSETT
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1201 E MICHIGAN AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1852
Mailing Address - Country:US
Mailing Address - Phone:517-841-1431
Mailing Address - Fax:517-817-7526
Practice Address - Street 1:1201 E MICHIGAN AVE
Practice Address - Street 2:STE 300
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1852
Practice Address - Country:US
Practice Address - Phone:517-841-1431
Practice Address - Fax:517-817-7526
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI26010001772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer