Provider Demographics
NPI:1720001431
Name:HARVEY, LINDSEY (PT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11320 INDUSTRIPLEX BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-295-8183
Mailing Address - Fax:225-295-8236
Practice Address - Street 1:328 S BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3444
Practice Address - Country:US
Practice Address - Phone:225-644-7510
Practice Address - Fax:225-644-2660
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06513225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H559C610Medicare PIN