Provider Demographics
NPI:1770704348
Name:POLEMITIS, LUCINDA KAY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:KAY
Last Name:POLEMITIS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:LUCINDA
Other - Middle Name:KAY
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:128 AMES ST
Mailing Address - Street 2:
Mailing Address - City:ELK RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49629-9739
Mailing Address - Country:US
Mailing Address - Phone:231-264-6682
Mailing Address - Fax:231-264-9188
Practice Address - Street 1:128 AMES ST
Practice Address - Street 2:
Practice Address - City:ELK RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49629-9739
Practice Address - Country:US
Practice Address - Phone:231-264-6682
Practice Address - Fax:231-264-9188
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT004521225100000X
MI5501015868225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist