Provider Demographics
NPI:1679700041
Name:WILLIAMSON, LINDSAY CLAIRE (PTA)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:CLAIRE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 HUNTERS RUN CV
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5700
Mailing Address - Country:US
Mailing Address - Phone:870-243-8222
Mailing Address - Fax:
Practice Address - Street 1:3423 E HIGHLAND DR
Practice Address - Street 2:SUITE A &B
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6404
Practice Address - Country:US
Practice Address - Phone:870-336-0021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA23202251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics