Provider Demographics
NPI:1801697628
Name:LINDSEY, JUSTIN KYLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:KYLE
Last Name:LINDSEY
Suffix:
Gender:
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 1:1350 NE STEPHENS ST STE 41
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-6410
Mailing Address - Country:US
Mailing Address - Phone:541-530-0938
Mailing Address - Fax:
Practice Address - Street 1:1350 NE STEPHENS ST STE 41
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-6410
Practice Address - Country:US
Practice Address - Phone:541-530-0938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR65377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist