Individual
LYNN INGALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSDPT
Contact information
Practice address
6343 E MAIN ST, SUITE 8, MESA, AZ 85205-8954
(480) 325-8838
(480) 325-9191
Mailing address
6343 E MAIN ST, SUITE 8, MESA, AZ 85205-8954
(480) 325-8838
(480) 325-9191
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
6228
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260534
—
AZ
Enumeration date
09/07/2011
Last updated
09/07/2011
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