Provider Demographics
NPI:1821676974
Name:SAMUELSON, LINDSAY (ND RSHOM)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:SAMUELSON
Suffix:
Gender:F
Credentials:ND RSHOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5242 EAGLE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1301
Mailing Address - Country:US
Mailing Address - Phone:419-450-0423
Mailing Address - Fax:
Practice Address - Street 1:5747 MAIN ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-1932
Practice Address - Country:US
Practice Address - Phone:419-517-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1056175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath