Provider Demographics
NPI:1205252608
Name:SCHRUHL, LINDSAY (ATC LAT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SCHRUHL
Suffix:
Gender:F
Credentials:ATC LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 HONEYGO CENTER DR
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9828
Mailing Address - Country:US
Mailing Address - Phone:443-910-8010
Mailing Address - Fax:443-725-2155
Practice Address - Street 1:5009 HONEYGO CENTER DR
Practice Address - Street 2:SUITE 209
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9828
Practice Address - Country:US
Practice Address - Phone:443-910-8010
Practice Address - Fax:443-725-2155
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00004152255A2300X
PART0053082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer