Provider Demographics
NPI:1508185091
Name:GOODMAN, LINDSAY FALLON (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:FALLON
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:LINDSAY
Other - Middle Name:FALLON
Other - Last Name:BENDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2718 SCIOTO STATION DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-3696
Mailing Address - Country:US
Mailing Address - Phone:614-634-8210
Mailing Address - Fax:
Practice Address - Street 1:2718 SCIOTO STATION DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3696
Practice Address - Country:US
Practice Address - Phone:614-634-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-23
Last Update Date:2010-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012661225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist