Basic Information
| Provider Information | |||||||||
| NPI: | 1750912564 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROWAN | ||||||||
| FirstName: | LINDSEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 309 MAYFIELD ST | ||||||||
| Address2: | |||||||||
| City: | WANATAH | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463909502 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 12800 MISSISSIPPI PKWY | ||||||||
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| City: | CROWN POINT | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463076900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2199211444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2020 | ||||||||
| LastUpdateDate: | 01/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 06004358A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.