Provider Demographics
NPI:1003508912
Name:BRIMHALL, LINDSAY RENEE
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:RENEE
Last Name:BRIMHALL
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 1:113 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5107
Mailing Address - Country:US
Mailing Address - Phone:970-833-5709
Mailing Address - Fax:
Practice Address - Street 1:113 FIFTH STREET
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5107
Practice Address - Country:US
Practice Address - Phone:970-833-5709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021898225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist