Provider Demographics
NPI:1689933806
Name:MYERS, LYNDA JEAN (LMT)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:JEAN
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20500 COT RD
Mailing Address - Street 2:UNIT 526
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-3800
Mailing Address - Country:US
Mailing Address - Phone:813-482-8913
Mailing Address - Fax:
Practice Address - Street 1:20500 COT RD
Practice Address - Street 2:UNIT 526
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-3800
Practice Address - Country:US
Practice Address - Phone:813-482-8913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55577225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist