Provider Demographics
NPI:1497420038
Name:DENSMORE, LINDSEY BETHANNE (DC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:BETHANNE
Last Name:DENSMORE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-1703
Mailing Address - Country:US
Mailing Address - Phone:440-488-9798
Mailing Address - Fax:
Practice Address - Street 1:1622 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7804
Practice Address - Country:US
Practice Address - Phone:440-488-9798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-7028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor