Provider Demographics
NPI:1871853556
Name:MCDANIEL, LINDSEY BROOKE (DPT)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:BROOKE
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 MOORE ST
Mailing Address - Street 2:2F
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1965
Mailing Address - Country:US
Mailing Address - Phone:609-204-0151
Mailing Address - Fax:
Practice Address - Street 1:2509 S 4TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-4712
Practice Address - Country:US
Practice Address - Phone:215-271-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022135225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist