Healthcare Provider Details

I. General information

NPI: 1144671157
Provider Name (Legal Business Name): LINDSEY BORDERS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2016
Last Update Date: 07/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 ELM ST NE
ALBUQUERQUE NM
87102-2500
US

IV. Provider business mailing address

1908 KRISS PL NE
ALBUQUERQUE NM
87112-4733
US

V. Phone/Fax

Practice location:
  • Phone: 505-823-9166
  • Fax:
Mailing address:
  • Phone: 505-710-0463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1610
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: