Individual
MRS. CAROLINE A LYALL
Active
Individual
MRS. CAROLINE A LYALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT9473
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000383509
ANTHEM PIN
OH
01
—
0989499
GROUP MEDICAID
OH
05
—
2550832
—
OH
01
—
CA1586
GROUP MEDICARE RAILROAD
—
Enumeration date
12/23/2005
Last updated
02/22/2012
Update your record
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