Provider Demographics
NPI:1669897237
Name:BOER, LINDSEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BOER
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 1:12457 TIMBERLAND BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5210
Mailing Address - Country:US
Mailing Address - Phone:817-562-5001
Mailing Address - Fax:817-568-5007
Practice Address - Street 1:12457 TIMBERLAND BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5210
Practice Address - Country:US
Practice Address - Phone:817-562-5001
Practice Address - Fax:817-568-5007
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1239510225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist