Provider Demographics
NPI:1134280506
Name:LAW, LINDSEY ANN (MED, ATC, LAT)
Entity type:Individual
Prefix:MISS
First Name:LINDSEY
Middle Name:ANN
Last Name:LAW
Suffix:
Gender:F
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 BROOKSTONE LN
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-9283
Mailing Address - Country:US
Mailing Address - Phone:404-713-0472
Mailing Address - Fax:
Practice Address - Street 1:2220 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2656
Practice Address - Country:US
Practice Address - Phone:404-785-8081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0010972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer