Provider Demographics
NPI:1689870503
Name:WOLFE, LINSEY SUZANNE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:LINSEY
Middle Name:SUZANNE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 FLAGDALE RD.
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43150-9719
Mailing Address - Country:US
Mailing Address - Phone:740-987-8300
Mailing Address - Fax:
Practice Address - Street 1:3680 DOLSON CT
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:OH
Practice Address - Zip Code:43112-9721
Practice Address - Country:US
Practice Address - Phone:740-654-0641
Practice Address - Fax:740-654-3896
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06433225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant