Provider Demographics
NPI:1558634139
Name:BRANDT, LINDSAY MARIE (DPT, ACSM-CES)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:BRANDT
Suffix:
Gender:F
Credentials:DPT, ACSM-CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2380 CEDAR ST
Mailing Address - Street 2:SUITE #203
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-2143
Mailing Address - Country:US
Mailing Address - Phone:517-709-4677
Mailing Address - Fax:517-798-5667
Practice Address - Street 1:2380 CEDAR ST
Practice Address - Street 2:SUITE #203
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-2143
Practice Address - Country:US
Practice Address - Phone:517-709-4677
Practice Address - Fax:517-798-5667
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
224Y00000X
MI5501015814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist