Provider Demographics
NPI:1356721161
Name:LINDELL, SHELLY (LMT)
Entity type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:
Last Name:LINDELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 W 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-2412
Mailing Address - Country:US
Mailing Address - Phone:907-830-3413
Mailing Address - Fax:
Practice Address - Street 1:3105 LAKESHORE DR
Practice Address - Street 2:SUITE B
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2815
Practice Address - Country:US
Practice Address - Phone:907-830-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-06
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist