Provider Demographics
NPI:1437534765
Name:THEIS, LINDSEY RAE (PT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RAE
Last Name:THEIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 DEHNE DR STE ABC
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:WI
Mailing Address - Zip Code:54421-9589
Mailing Address - Country:US
Mailing Address - Phone:715-223-6442
Mailing Address - Fax:715-223-2447
Practice Address - Street 1:120 DEHNE DR STE ABC
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:WI
Practice Address - Zip Code:54421-9589
Practice Address - Country:US
Practice Address - Phone:715-223-6442
Practice Address - Fax:715-223-2447
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10021225100000X
WI14021-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist