Provider Demographics
NPI:1710594676
Name:BOWDEN, LINDSAY EDGE (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:EDGE
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:TAYLOR
Other - Last Name:EDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1991 FORDHAM DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3773
Mailing Address - Country:US
Mailing Address - Phone:910-484-4653
Mailing Address - Fax:910-483-9256
Practice Address - Street 1:1991 FORDHAM DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3773
Practice Address - Country:US
Practice Address - Phone:910-484-4653
Practice Address - Fax:910-483-9256
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19806225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist