Provider Demographics
NPI:1730308008
Name:FLEMMEN, LINDI MARIE (PT)
Entity Type:Individual
Prefix:
First Name:LINDI
Middle Name:MARIE
Last Name:FLEMMEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDI
Other - Middle Name:MARIE
Other - Last Name:SCHLOTTHAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:823 BELKNAP ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-2960
Mailing Address - Country:US
Mailing Address - Phone:715-394-6355
Mailing Address - Fax:715-394-2191
Practice Address - Street 1:823 BELKNAP ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-2960
Practice Address - Country:US
Practice Address - Phone:715-394-6355
Practice Address - Fax:715-394-2191
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10776225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1730308008Medicaid
WI10776OtherLICENSE
WI10776OtherLICENSE
WIK400142588Medicare PIN