Provider Demographics
NPI:1881805703
Name:BRANSTETTER, LINDSEY MICHELLE (PTA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MICHELLE
Last Name:BRANSTETTER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-3232
Mailing Address - Country:US
Mailing Address - Phone:419-569-4469
Mailing Address - Fax:
Practice Address - Street 1:1600 CRIDER RD
Practice Address - Street 2:
Practice Address - City:MASFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903
Practice Address - Country:US
Practice Address - Phone:419-589-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06266225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant