Provider Demographics
NPI:1225401904
Name:RANKIN, LINDSAY ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ANN
Last Name:RANKIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 E 1200 N
Mailing Address - Street 2:
Mailing Address - City:SHELLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83274-5021
Mailing Address - Country:US
Mailing Address - Phone:801-602-2651
Mailing Address - Fax:
Practice Address - Street 1:2785 EAGLE DR APT G106
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-5763
Practice Address - Country:US
Practice Address - Phone:801-602-2651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 41770225100000X
UT8963796-2401225100000X
IDPT-3453225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist