Provider Demographics
NPI:1154676849
Name:BURGESS, LINDSEY (PT)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:BURGESS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 E BOSWELL ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-5726
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1409 MALCOLM AVE
Practice Address - Street 2:STE. D
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3617
Practice Address - Country:US
Practice Address - Phone:870-523-6500
Practice Address - Fax:870-523-6508
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist