Provider Demographics
NPI:1518058999
Name:HALLOWELL-GOTTSLEBEN, LYNN RENEE (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:RENEE
Last Name:HALLOWELL-GOTTSLEBEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:RENEE
Other - Last Name:HALLOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:5401 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2150
Mailing Address - Country:US
Mailing Address - Phone:402-483-9502
Mailing Address - Fax:402-486-8285
Practice Address - Street 1:5401 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2150
Practice Address - Country:US
Practice Address - Phone:402-486-7704
Practice Address - Fax:402-486-7701
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist