Healthcare Provider Details

I. General information

NPI: 1134952112
Provider Name (Legal Business Name): LINDSAY CAROLYN SIDES PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW STE 750
WASHINGTON DC
20006-1023
US

IV. Provider business mailing address

7 M ST NE APT 623
WASHINGTON DC
20002-4382
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-1853
  • Fax:
Mailing address:
  • Phone: 214-793-9783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP033582T
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1395493
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: