Provider Demographics
NPI:1043718935
Name:HARTIG, LYNSEY NICOLE
Entity type:Individual
Prefix:
First Name:LYNSEY
Middle Name:NICOLE
Last Name:HARTIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6192 SENECA CT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-9214
Mailing Address - Country:US
Mailing Address - Phone:614-406-0192
Mailing Address - Fax:
Practice Address - Street 1:6192 SENECA CT
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9214
Practice Address - Country:US
Practice Address - Phone:614-406-0192
Practice Address - Fax:614-406-0192
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer