Provider Demographics
NPI:1982096152
Name:BEARD, LYNDSI LUANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:LYNDSI
Middle Name:LUANNE
Last Name:BEARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 16TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1818
Mailing Address - Country:US
Mailing Address - Phone:580-223-5900
Mailing Address - Fax:580-223-5565
Practice Address - Street 1:804 16TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1818
Practice Address - Country:US
Practice Address - Phone:580-223-5900
Practice Address - Fax:580-223-5565
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor