Provider Demographics
NPI:1376330571
Name:LINDGREN, MAX JAY
Entity type:Individual
Prefix:
First Name:MAX
Middle Name:JAY
Last Name:LINDGREN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 NW 96TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1640
Mailing Address - Country:US
Mailing Address - Phone:308-999-7890
Mailing Address - Fax:
Practice Address - Street 1:229 S STEWART RD STE E3
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-4206
Practice Address - Country:US
Practice Address - Phone:816-656-3695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist