Provider Demographics
NPI:1366024101
Name:KENNEDY, LINDSAY ERIN (LMT)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:ERIN
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 E HIGH ST UNIT 1549
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-7982
Mailing Address - Country:US
Mailing Address - Phone:484-366-5566
Mailing Address - Fax:
Practice Address - Street 1:1866 E HIGH ST # B
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3208
Practice Address - Country:US
Practice Address - Phone:610-323-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG013103225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist