Provider Demographics
NPI:1891839031
Name:MONROE, LYNN ELIZABETH (PT)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ELIZABETH
Last Name:MONROE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-2106
Mailing Address - Country:US
Mailing Address - Phone:812-235-1197
Mailing Address - Fax:812-235-1197
Practice Address - Street 1:326 S 20TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-2106
Practice Address - Country:US
Practice Address - Phone:812-235-1197
Practice Address - Fax:812-235-1197
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001154A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist