Provider Demographics
NPI:1649623976
Name:LINDSEY, JENNIFER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 TARA CT
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-7560
Mailing Address - Country:US
Mailing Address - Phone:270-875-3568
Mailing Address - Fax:
Practice Address - Street 1:232 TARA CT
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-7560
Practice Address - Country:US
Practice Address - Phone:270-875-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006046225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist