Basic Information
Provider Information
NPI: 1982917159
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COYNE
FirstName: LINDSAY
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 50233 CINDY DR
Address2:  
City: SAINT CLAIRSVILLE
State: OH
PostalCode: 439508507
CountryCode: US
TelephoneNumber: 7402960294
FaxNumber:  
Practice Location
Address1: 917 BEVILLE RD
Address2:  
City: SOUTH DAYTONA
State: FL
PostalCode: 321191712
CountryCode: US
TelephoneNumber: 3867564395
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/16/2010
LastUpdateDate: 07/16/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X12661NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home