MEDICARE: LINDSEY LUKASON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1023639044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY LUKASON

Provider Business Mailing Address
First Line	:	161 19TH ST S STE 101
Second Line	:
City	:	SARTELL
State	:	MN
Zip	:	56377-2555
Country	:	US
Telephone Number	:	320-257-0360
Fax Number	:

Provider Business Practice Location Address
First Line	:	161 19TH ST S STE 101
Second Line	:
City	:	SARTELL
State	:	MN
Zip	:	56377-2555
Country	:	US
Telephone Number	:	320-257-0360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2020
Last Update Date	:	04/30/2020

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Directions to “ LINDSEY LUKASON ” Practice Location

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