Healthcare Provider Details

I. General information

NPI: 1225528920
Provider Name (Legal Business Name): LINDSEY ELIZABETH KOTSCHWAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 N GREEN ST
VALENTINE NE
69201-1932
US

IV. Provider business mailing address

1102 E 9TH ST APT 5
VALENTINE NE
69201-1866
US

V. Phone/Fax

Practice location:
  • Phone: 402-376-2525
  • Fax:
Mailing address:
  • Phone: 308-289-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0493
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number1514
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: