Provider Demographics
NPI:1528366671
Name:MALTAS, LINDSAY ANN
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ANN
Last Name:MALTAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:ANN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:715 SW ANKENY RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-9798
Mailing Address - Country:US
Mailing Address - Phone:515-289-9605
Mailing Address - Fax:515-965-1186
Practice Address - Street 1:675 SW ANKENY RD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9720
Practice Address - Country:US
Practice Address - Phone:515-965-1339
Practice Address - Fax:515-965-1186
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist