Provider Demographics
NPI:1013105345
Name:LINDSEY, KEVIN BRENT (PT)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:BRENT
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2513 CRESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-6091
Mailing Address - Country:US
Mailing Address - Phone:215-779-0846
Mailing Address - Fax:
Practice Address - Street 1:2513 CRESTLINE DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-6091
Practice Address - Country:US
Practice Address - Phone:215-779-0846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225100000X
TX1127124225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist