Provider Demographics
NPI:1639723398
Name:LYNSKEY, MADISON PAIGE (AD, PTA)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:PAIGE
Last Name:LYNSKEY
Suffix:
Gender:M
Credentials:AD, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 82ND ST STE 107
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-3366
Mailing Address - Country:US
Mailing Address - Phone:806-319-7488
Mailing Address - Fax:806-368-5935
Practice Address - Street 1:4413 82ND ST STE 107
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3366
Practice Address - Country:US
Practice Address - Phone:806-319-7488
Practice Address - Fax:806-368-5935
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2147756225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant