Provider Demographics
NPI:1225189566
Name:ROTHERING, LINDSAY M N (PT)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:M N
Last Name:ROTHERING
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 1:3026 SNOWCAP TRL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-5823
Mailing Address - Country:US
Mailing Address - Phone:608-845-9163
Mailing Address - Fax:
Practice Address - Street 1:436 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:SPRING GREEN
Practice Address - State:WI
Practice Address - Zip Code:53588-9286
Practice Address - Country:US
Practice Address - Phone:608-588-2502
Practice Address - Fax:608-588-7724
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10250024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36100700Medicaid