Provider Demographics
NPI:1609105220
Name:POLANSKI, LYNDSAY
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:
Last Name:POLANSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYNDSAY
Other - Middle Name:
Other - Last Name:BONDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4201 CAROLINA EXCHANGE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4221
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 CAROLINA EXCHANGE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4221
Practice Address - Country:US
Practice Address - Phone:843-455-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT002887225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist