Provider Demographics
NPI:1265672349
Name:LINDSAY, KENNETH LESLIE
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:LESLIE
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 BLACK WARRIOR DR APT C
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36110-3094
Mailing Address - Country:US
Mailing Address - Phone:313-995-8898
Mailing Address - Fax:
Practice Address - Street 1:3017 BLACK WARRIOR DR APT C
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36110-3094
Practice Address - Country:US
Practice Address - Phone:313-995-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist