Provider Demographics
NPI:1508322173
Name:HARTMAN, LINDSAY KYONG (OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:KYONG
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9871 ZIEGELS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-2249
Mailing Address - Country:US
Mailing Address - Phone:484-695-2845
Mailing Address - Fax:
Practice Address - Street 1:265 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2221
Practice Address - Country:US
Practice Address - Phone:215-379-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
PAOC015807225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist