Provider Demographics
NPI:1275839656
Name:DEXTER, LINDSAY MAE (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MAE
Last Name:DEXTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SAINT ANDREWS CT STE 310
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-8805
Mailing Address - Country:US
Mailing Address - Phone:507-388-5437
Mailing Address - Fax:319-354-4819
Practice Address - Street 1:150 SAINT ANDREWS CT STE 310
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-8805
Practice Address - Country:US
Practice Address - Phone:507-388-5437
Practice Address - Fax:507-388-2108
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10748225100000X
IA004680225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1213Medicare PIN
IAIB1212018Medicare PIN
IAIB1213016Medicare PIN
IAIB1212Medicare PIN