Provider Demographics
NPI:1902238967
Name:BLAKE, LINDSEY P (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:P
Last Name:BLAKE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:13700 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3222
Practice Address - Country:US
Practice Address - Phone:804-379-9086
Practice Address - Fax:804-379-1283
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2016-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305208144225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist