Provider Demographics
NPI:1619189073
Name:RUPP, LINDSAY JEAN (ATC)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:JEAN
Last Name:RUPP
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 W CLARK ST
Mailing Address - Street 2:APT 202
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-1772
Mailing Address - Country:US
Mailing Address - Phone:712-229-0436
Mailing Address - Fax:
Practice Address - Street 1:414 E CLARK ST
Practice Address - Street 2:
Practice Address - City:VERMILLION
Practice Address - State:SD
Practice Address - Zip Code:57069-2307
Practice Address - Country:US
Practice Address - Phone:605-644-5069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer