Provider Demographics
NPI:1457417560
Name:KAMINSKIS, LINDA KAY (ATC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:KAY
Last Name:KAMINSKIS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22497 FIRESIDE DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-8479
Mailing Address - Country:US
Mailing Address - Phone:574-875-3534
Mailing Address - Fax:
Practice Address - Street 1:1700 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-4724
Practice Address - Country:US
Practice Address - Phone:574-535-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000120A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer