Basic Information
| Provider Information | |||||||||
| NPI: | 1558671669 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FELKER | ||||||||
| FirstName: | LINDSAY | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 W 10TH ST | ||||||||
| Address2: | |||||||||
| City: | MARCUS HOOK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190614513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108598850 | ||||||||
| FaxNumber: | 6108597876 | ||||||||
| Practice Location | |||||||||
| Address1: | 4301 PENN AVE | ||||||||
| Address2: | |||||||||
| City: | SINKING SPRING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196081370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109274136 | ||||||||
| FaxNumber: | 6109274139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2010 | ||||||||
| LastUpdateDate: | 06/09/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT-020957 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 2526470 | 01 | PABS | OTHER | 2526470 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 102524683-0001 | 05 | PA | MEDICAID | 1558671669 | 01 | PA | BRAVO | OTHER | 30084967 | 01 | PA | KEYSTONE MERCY | OTHER | 3805426000 | 01 | PA | INDEPENDENCE BLUE CROSS | OTHER |