Provider Demographics
NPI:1619399185
Name:SIMONETTI, LYNN MARGARET (PT, MA)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MARGARET
Last Name:SIMONETTI
Suffix:
Gender:F
Credentials:PT, MA
Other - Prefix:MRS
Other - First Name:LYNN
Other - Middle Name:MARGARET
Other - Last Name:HANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:225 CHATHAM RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3313
Mailing Address - Country:US
Mailing Address - Phone:614-361-7213
Mailing Address - Fax:
Practice Address - Street 1:225 CHATHAM RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3313
Practice Address - Country:US
Practice Address - Phone:614-538-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3424225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist