Provider Demographics
NPI:1356739791
Name:HIXON, LINDSAY MARIE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:MARIE
Last Name:HIXON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:LINDSAY
Other - Middle Name:MARIE
Other - Last Name:TISDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4100 LAKE OTIS PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5230
Mailing Address - Country:US
Mailing Address - Phone:907-563-3145
Mailing Address - Fax:833-464-5196
Practice Address - Street 1:4100 LAKE OTIS PKWY STE 108
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5230
Practice Address - Country:US
Practice Address - Phone:907-563-3145
Practice Address - Fax:833-464-5196
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28521225100000X
AK2704225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist