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Individual

DR. LINDSAY JANE SOUTHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-6572
Mailing address
2765 LOCH RAVEN BLVD APT A, COPLEY, OH 44321-2163

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017080
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17153
NORTH CAROLINA BOARD OF PHYSICAL THERAPY EXAMINERS
NC
01
PT017080
OHIO OCCUPATIONAL THERAPY, PHYSICAL THERAPY AND ATHLETIC TRAINER BOARD LICENSE
OH
Enumeration date
12/11/2017
Last updated
12/11/2017
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