Provider Demographics
NPI:1205065430
Name:MITCHELL, LINDSEY FROST (DPT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:FROST
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:FROST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3125 INDEPENDENCE DR
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4159
Mailing Address - Country:US
Mailing Address - Phone:205-879-7501
Mailing Address - Fax:205-879-0675
Practice Address - Street 1:3125 INDEPENDENCE DR
Practice Address - Street 2:SUITE 300B
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4159
Practice Address - Country:US
Practice Address - Phone:205-879-7501
Practice Address - Fax:205-879-0675
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH5572225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51599304OtherBLUE CROSS BLUE SHEILD OF ALALBAMA
ALPTH5572OtherPHYSICAL THERAPY LICENSE NUMBER
AL51599304OtherBLUE CROSS BLUE SHEILD OF ALALBAMA