Provider Demographics
NPI:1417901547
Name:LINDSAY, MARK L (PT, MS, CHT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:L
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:PT, MS, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 BRIGHTON PLACE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2382
Mailing Address - Country:US
Mailing Address - Phone:859-263-0021
Mailing Address - Fax:
Practice Address - Street 1:230 FOUNTAIN CT
Practice Address - Street 2:SUITE 350
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1888
Practice Address - Country:US
Practice Address - Phone:859-263-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000494OtherPT STATE LICENSE