Provider Demographics
NPI:1992357131
Name:LOEWE, LINDSAY J
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:J
Last Name:LOEWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W MADISON ST # A
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1120
Mailing Address - Country:US
Mailing Address - Phone:574-286-2451
Mailing Address - Fax:
Practice Address - Street 1:326 W MADISON ST # A
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1120
Practice Address - Country:US
Practice Address - Phone:574-340-4393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist