Provider Demographics
NPI:1801049655
Name:BAINEY, LINDSAY C (MPT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:C
Last Name:BAINEY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2217
Mailing Address - Country:US
Mailing Address - Phone:814-944-6535
Mailing Address - Fax:814-944-6545
Practice Address - Street 1:2510 7TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2217
Practice Address - Country:US
Practice Address - Phone:814-944-6535
Practice Address - Fax:814-944-6545
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013619L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1037129910002OtherGROUP MEDICAID
PA1037233870001Medicaid
PA796981OtherGROUP MEDICARE PTAN