Provider Demographics
NPI:1639563224
Name:O'KEEFE, LYNDSEY ROSE (PT, DPT, NCS)
Entity Type:Individual
Prefix:MRS
First Name:LYNDSEY
Middle Name:ROSE
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:ROSE
Other - Last Name:SOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, NCS
Mailing Address - Street 1:1800 30TH STREET
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1026
Mailing Address - Country:US
Mailing Address - Phone:303-546-9201
Mailing Address - Fax:303-545-5080
Practice Address - Street 1:1800 30TH STREET
Practice Address - Street 2:SUITE 215
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1026
Practice Address - Country:US
Practice Address - Phone:303-546-9201
Practice Address - Fax:303-545-5080
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0016853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ06873ZMedicare PIN
CACA151889Medicare PIN