Provider Demographics
NPI:1538246426
Name:LANKFORD, LINDSAY MARIE (PT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:LANKFORD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MARIE
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4200 DAHLBERG DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4841
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:
Practice Address - Street 1:2700 VIKINGS CIR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1002
Practice Address - Country:US
Practice Address - Phone:952-456-7600
Practice Address - Fax:952-456-7601
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7839225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN244505Medicare ID - Type Unspecified
MN244515Medicare ID - Type Unspecified